结直肠癌中小乳头状结构的临床病理意义。

The clinicopathological significance of micropapillary pattern in colorectal cancers.

机构信息

Department of Pathology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea.

出版信息

Hum Pathol. 2018 Jul;77:159-165. doi: 10.1016/j.humpath.2018.02.027. Epub 2018 Apr 7.

DOI:10.1016/j.humpath.2018.02.027

Abstract

The aim of the present study is to elucidate the clinicopathological significance and prognostic role of micropapillary pattern (MPP) in colorectal cancer (CRC). We investigated the correlation between the presence of MPP and clinicopathological characteristics and prognosis in 266 CRCs. In addition, the clinicopathological significance of MPP in mucin pools was investigated and compared to pure MPP, which is not associated with mucin pools. MPP, regardless of its proportion in the overall tumor, was found in 74 of 266 CRCs (27.8%). The rate of MPP in proportions ≥5% was 9.4% (25 of 266 cases). CRC with MPP showed higher rates of vascular and lymphatic invasion, higher metastatic lymph node ratio, and higher pT stage compared to CRC without MPP. In addition, increasing proportion of MPP in overall tumor showed more frequent vascular and lymphatic invasions (P = .002 and P = .008, respectively). Among 74 CRCs with MPP, 25 CRCs were found in mucin pools (33.8%). These cases were more right-sided and poorly differentiated with less frequent lymphatic invasion and lymph node metastasis, compared to CRCs with pure MPP. The presence of MPP significantly correlated with worse overall survival (P = .010). In 74 CRCs with MPP, overall survival significantly differed between pure MPP and MPP in mucin pools (P = .003). Taken together, our data suggest that the presence of MPP significantly correlated with aggressive tumor behavior and worse survival in CRC. In addition, the clinicopathological significance of MPP in mucin pools differed from CRC with pure MPP.

摘要

本研究旨在阐明微乳头状模式（MPP）在结直肠癌（CRC）中的临床病理意义和预后作用。我们研究了 MPP 的存在与 266 例 CRC 的临床病理特征和预后之间的相关性。此外，还研究了 MPP 在黏液池中的临床病理意义，并与不伴有黏液池的纯 MPP 进行了比较。结果发现，在 266 例 CRC 中，无论 MPP 在整个肿瘤中的比例如何，有 74 例（27.8%）存在 MPP。MPP 比例≥5%的发生率为 9.4%（25/266 例）。与无 MPP 的 CRC 相比，有 MPP 的 CRC 具有更高的血管和淋巴管侵犯率、更高的转移性淋巴结比例和更高的 pT 分期。此外，肿瘤中 MPP 比例的增加与更频繁的血管和淋巴管侵犯有关（P=0.002 和 P=0.008）。在有 MPP 的 74 例 CRC 中，有 25 例存在于黏液池（33.8%）。与纯 MPP 的 CRC 相比，这些病例更多发生于右半结肠，分化程度较低，且淋巴管侵犯和淋巴结转移的频率较低。MPP 的存在与总生存率显著相关（P=0.010）。在有 MPP 的 74 例 CRC 中，纯 MPP 和 MPP 在黏液池中的总生存率存在显著差异（P=0.003）。综上所述，我们的数据表明，MPP 的存在与 CRC 侵袭性行为和生存率下降显著相关。此外，MPP 在黏液池中的临床病理意义与纯 MPP 的 CRC 不同。