Department of Pathology, Beijing Chaoyang Hospital, Capital University, Beijing, China.
PLoS One. 2018 Apr 9;13(4):e0194804. doi: 10.1371/journal.pone.0194804. eCollection 2018.
The aims of this study were to evaluate the associations between peritoneal elastic lamina invasion (ELI) and the clinicopathological prognostic factors of colon cancer, to evaluate the feasibility of ELI with use of an elastic stain to help diagnose serosal invasion of colon cancer in routine practice, so as to help us to provide a more accurate estimate for prognosis and stage of patients and a marker for postoperative treatment.
254 cases with colon cancer were included in the study. According to the presence of elastic lamina (EL) and elastic lamina invasion (ELI), all cases were divided into four groups: pT3 EL negative (pT3 EL (-)), pT3 ELI positive (pT3 ELI (+)), pT3 ELI negative (pT3 ELI (-)) and pT4a. Statistical analysis was used to analyze the relationship between elastic lamina invasion and other established adverse histologic features.
The EL and ELI positive rates were 81.5% and 42.1% respectively. There were significant differences in mph node metastasis, venous invasion and tumor buds between pT3 ELI (-) and pT3 ELI (+), pT3 ELI (-) and pT4a. There was no significant difference in same factors between pT3 ELI (+) and pT4a. In pT3 stage, there were significant differences in lymph node metastasis, perineural invasion and tumor buds between EL (-) and ELI (+). There were no significant differences in same factors between EL (-) and ELI (-). EL was detected less frequently in right-sided tumors compared with left-sided tumors.
ELI might be the prognostic factors of colon cancer with II stage and might be the marker of postoperative adjuvant chemotherapy. Patients with pT3 ELI (+) might have similar prognosis to patients with pT4a. For patients with pT3 colon cancer, EL(-) might have similar prognosis as ELI (-) and might take the same therapy. In addition, the right half colon EL positive rate was lower than the left colon. Elastic staining might be a useful tool to help determine the invasive depth and stage of colon cancer.
本研究旨在评估腹膜弹性层侵犯（ELI）与结肠癌临床病理预后因素的关系，评估弹性染色在帮助诊断结肠癌浆膜侵犯中的可行性，以便为患者提供更准确的预后和分期估计，并作为术后治疗的标志物。
本研究纳入 254 例结肠癌患者。根据弹性层（EL）和弹性层侵犯（ELI）的存在情况，将所有病例分为四组：pT3 EL 阴性（pT3 EL (-)）、pT3 ELI 阳性（pT3 ELI (+）、pT3 ELI 阴性（pT3 ELI (-)）和 pT4a。统计分析用于分析弹性层侵犯与其他已建立的不良组织学特征之间的关系。
EL 和 ELI 的阳性率分别为 81.5%和 42.1%。pT3 ELI (-)与 pT3 ELI (+）、pT3 ELI (-)与 pT4a 之间在mph 淋巴结转移、静脉侵犯和肿瘤芽方面存在显著差异。pT3 ELI (+）与 pT4a 之间在同一因素上无显著差异。在 pT3 期，EL(-)与 ELI (+）之间在淋巴结转移、神经周围侵犯和肿瘤芽方面存在显著差异。EL(-)与 ELI (-）之间在同一因素上无显著差异。右侧肿瘤的 EL 检测频率低于左侧肿瘤。
ELI 可能是结肠癌 II 期的预后因素，可能是术后辅助化疗的标志物。pT3 ELI (+）患者的预后可能与 pT4a 患者相似。对于 pT3 结肠癌患者，EL(-)的预后可能与 ELI (-）相似，可能采用相同的治疗方法。此外，右半结肠的 EL 阳性率低于左半结肠。弹性染色可能是一种有用的工具，有助于确定结肠癌的浸润深度和分期。
