van Eeghen E E, Flens M J, Mulder M M R, Loffeld R J L F
Department of Internal Medicine, Zaans Medisch Centrum, Zaandam, Netherlands.
Department of Pathology, Zaans Medisch Centrum, Zaandam, Netherlands.
Gastroenterol Res Pract. 2017;2017:1598670. doi: 10.1155/2017/1598670. Epub 2017 Nov 28.
Extramural venous invasion (EMVI) is a prognostic indicator in patients with colorectal cancer. However, its additional value in patients with stage 1 and 2 colorectal cancer is uncertain. In the present study, the incidence of EMVI and the hazard ratio for recurrence in patients with stage 1 and 2 colon cancer were studied.
184 patients treated for stage 1 and 2 colon cancer were included with a follow-up of at least 5 years. Chart review was performed and EMVI was assessed by two separate pathologists. EMVI was scored with additional caldesmon staining on the resection specimen. Primary outcomes were recurrence-free survival (RFS) measured through the Cox regression analysis and prevalence of EMVI.
There were 10 cases of EMVI and 3 cases of intramural venous invasion (IMVI) all occurring in patients with stage 2 disease corresponding to a prevalence of 9%. Thirty-one percent of the patients with venous invasion experienced recurrence versus 14% in patients without, corresponding with a hazard ratio of 2.39 ( = 0.11).
The present study demonstrates a trend towards an increased risk of recurrence in patients with stage 2 colon cancer with venous invasion. This warrants consideration of adjuvant chemotherapy despite the lack of lymph node metastases.
壁外静脉侵犯（EMVI）是结直肠癌患者的一个预后指标。然而，其在1期和2期结直肠癌患者中的附加价值尚不确定。在本研究中，对1期和2期结肠癌患者的EMVI发生率及复发风险比进行了研究。
纳入184例接受1期和2期结肠癌治疗的患者，随访至少5年。进行病历审查，由两名独立病理学家评估EMVI。通过对切除标本进行额外的钙调蛋白染色对EMVI进行评分。主要结局是通过Cox回归分析测量的无复发生存期（RFS）和EMVI的患病率。
有10例EMVI和3例壁内静脉侵犯（IMVI），均发生在2期疾病患者中，患病率为9%。有静脉侵犯的患者中有31%出现复发，而无静脉侵犯的患者中这一比例为14%，风险比为2.39（P = 0.11）。
本研究表明，有静脉侵犯的2期结肠癌患者复发风险有增加的趋势。尽管没有淋巴结转移，但这值得考虑辅助化疗。
