Attencourt Christophe, Sabbagh Charles, Meynier Jonathan, Grados Lucien, Regimbeau Jean-Marc, Chatelain Denis
Service d'anatomie pathologique, CHU d'Amiens, chemin de Longpré, 80080 Amiens, France.
Service de chirurgie digestive, CHU d'Amiens, chemin de Longpré, 80080 Amiens, France.
Ann Pathol. 2018 Dec;38(6):352-362. doi: 10.1016/j.annpat.2018.02.003. Epub 2018 May 26.
The aim of our study was to assess the value of Elastic stain in the diagnosis of venous invasion (VI) in colonic adenocarcinoma.
All patients who undergone surgery for colonic adenocarcinoma at the University Hospital of Amiens, between 2004 and 2007, were included. Hematein-phloxin-saffron (HPS) stained slides of colectomy specimens were reviewed by two pathologists. Tumor blocks were stained with Elastic Stain (Roche - Ventana). The presence or absence of VI, their number and localization were correlated with overall survival.
Two hundred and thirty-one cases were investigated and 3274 slides were examined. VI were more often diagnosed by Elastic Stain than HPS stain (66% vs. 40%). Ninety percent of VI were revealed within the first 6 HPS slides, and from the first 5 in Elastic Stain. The presence of VI revealed by Elastic Stain and/or HPS was significantly associated with decreased overall survival in multivariate analysis (P=0.029), especially for stage IIA tumors (P=0.016). Tumor differentiation (P=0.006) and pTNM stage (P=0.001) were also independent prognostic factors. The localization and the number of VI were not prognostic factors.
Our study confirms the prognostic value of VI, revealed by an elastic stain, in colonic adenocarcinoma. A systematic elastic stain of all tumor blocks (number at least 5) could be considered in the future, during pathological examination of colectomy for adenocarcinoma.
我们研究的目的是评估弹性染色在诊断结肠腺癌静脉侵犯(VI)中的价值。
纳入2004年至2007年间在亚眠大学医院接受结肠腺癌手术的所有患者。两名病理学家对苏木精 - 派洛宁 - 番红(HPS)染色的结肠切除术标本玻片进行了复查。肿瘤组织块用弹性染色(罗氏 - 文塔纳)进行染色。VI的有无、数量和定位与总生存期相关。
共调查了231例病例,检查了3274张玻片。弹性染色诊断VI的比例高于HPS染色(66%对40%)。90%的VI在最初6张HPS玻片内被发现,而在弹性染色中则是在前5张内。在多因素分析中,弹性染色和/或HPS显示的VI的存在与总生存期降低显著相关(P = 0.029),特别是对于IIA期肿瘤(P = 0.016)。肿瘤分化(P = 0.006)和pTNM分期(P = 0.001)也是独立的预后因素。VI的定位和数量不是预后因素。
我们的研究证实了弹性染色显示的VI在结肠腺癌中的预后价值。未来在腺癌结肠切除术的病理检查中,可考虑对所有肿瘤组织块(数量至少为5块)进行系统性弹性染色。