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黏液组织学亚型对结直肠癌患者肿瘤学结局的预后意义

Prognostic Significance of Mucinous Histologic Subtype on Oncologic Outcomes in Patients With Colorectal Cancer.

作者信息

Hosseini Sare, Bananzadeh Ali Mohammad, Salek Roham, Zare-Bandamiri Mohammad, Kermani Ali Taghizadeh, Mohammadianpanah Mohammad

机构信息

Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Ann Coloproctol. 2017 Apr;33(2):57-63. doi: 10.3393/ac.2017.33.2.57. Epub 2017 Apr 28.

Abstract

PURPOSE

Mucinous adenocarcinomas account for about 10% of all colorectal cancers. This study aimed to investigate the prognostic impact of mucinous histologic subtype on oncologic outcomes in patients with colorectal cancer.

METHODS

This retrospective study was performed at two large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of patients with colorectal cancer who were treated and followed up between 2000 and 2013.

RESULTS

Totally, 144 of 1,268 patients with a colorectal adenocarcinoma (11.4%) had mucinous histologic subtype. Statistically significant results found in this research are as follows: Mucinous histologic subtype tended to present in younger patients and to have larger tumor size, higher histologic grade, higher node stage, larger number of positive nodes, and higher rate of perineural invasion compared to nonmucinous histologic subtype. On the univariate analysis, mucinous subtype was a prognostic factor for disease-free and overall survival. On the multivariate analysis, primary tumor location, node stage and lymphatic-vascular invasion were independent prognostic factors for the local control rate. Rectal tumor location, higher disease stage, tumor grade II, and presence of lymphatic-vascular invasion had negative influences on disease-free survival, as did rectal tumor location, higher disease stage and presence of lymphatic-vascular invasion on overall survival.

CONCLUSION

Mucinous histologic subtype was associated with some adverse pathologic features in patients with colorectal cancer; however, it was not an independent prognostic factor for oncologic outcome.

摘要

目的

黏液腺癌约占所有结直肠癌的10%。本研究旨在探讨黏液组织学亚型对结直肠癌患者肿瘤学结局的预后影响。

方法

这项回顾性研究在两家大型三级大学医院进行。我们分析了2000年至2013年间接受治疗和随访的结直肠癌患者的特征、预后因素和生存率。

结果

在1268例结直肠腺癌患者中,共有144例(11.4%)为黏液组织学亚型。本研究发现的具有统计学意义的结果如下:与非黏液组织学亚型相比,黏液组织学亚型倾向于出现在年轻患者中,且肿瘤体积更大、组织学分级更高、淋巴结分期更高、阳性淋巴结数量更多以及神经周围侵犯率更高。单因素分析显示,黏液亚型是无病生存期和总生存期的预后因素。多因素分析显示,原发肿瘤位置、淋巴结分期和淋巴管侵犯是局部控制率的独立预后因素。直肠肿瘤位置、疾病分期较高、肿瘤分级为II级以及存在淋巴管侵犯对无病生存期有负面影响,直肠肿瘤位置、疾病分期较高以及存在淋巴管侵犯对总生存期也有负面影响。

结论

黏液组织学亚型与结直肠癌患者的一些不良病理特征相关;然而,它不是肿瘤学结局的独立预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c113/5426204/6207f6361073/ac-33-57-g001.jpg

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