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[结直肠癌中低分化簇的临床病理意义]

[Clinicopathological significance of poorly differentiated clusters in colorectal adenocarcinoma].

作者信息

Yang L L, Gou S Q, Wang J S, Qi Q, Huang W B

机构信息

Department of Pathology, Nanjing Hospital(Nanjing First Hospital), Nanjing Medical University, Nanjing 210006, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2019 Apr 8;48(4):276-281. doi: 10.3760/cma.j.issn.0529-5807.2019.04.003.

Abstract

To investigate the correlation between poorly differentiated clusters (PDCs) in colorectal adenocarcinomas with clinicopathological parameters and its clinicopathological significance. One hundred and eighty-three colorectal adenocarcinomas resected by radical proctocolecomy were collected at Nanjing Hospital(Nanjing First Hospital), Nanjing Medical University, from January to December 2017. There were 122 male and 61 female patients with age ranging from 42 to 89 years (mean of 68 years). Tumor diameter ranged from 2 to 14 cm (mean 4.5 cm). There were 124 colon cancers and 59 rectal cancers. The number and grade of PDCs in the colorectal adenocarcinoma were evaluated by H-E staining. The overall peritumoural inflammatory reaction was also evaluated. The relationship between PDCs and tumor grades and clinicopathological features and overall peritumoural inflammatory reaction of colorectal adenocarcinoma was analyzed. Of 183 cases of colorectal adenocarcinoma, PDCs were seen in 104 cases (56.8%), of which 36 cases (19.7%) were grade 1, 28 cases (15.3%) were grade 2, and 40 cases (21.9%) were grade 3. PDCs were positively correlated with lymph node metastasis, vascular invasion, degree of differentiation, depth of invasion, and pTNM staging(0.05). The detection rate of PDCs in colon cancer was higher than that of rectal cancer(0.05). PDCs was unrelated to age, gender, tumor size, and degree of overall peritumoural inflammatory reaction (0.05). Among clinicopathological parameters, the grade of PDCs was correlated with lymph node metastasis and vascular invasion (higher than those without lymph node metastasis and vascular invasion, 0.05); There was a positive correlation between the grade of PDCs and age, tumor differentiation and pTNM staging(0.05), and no significant difference between the grade of PDCs and gender, tumor size, tumor location, and depth of invasion was seen (0.05). There was no correlation between the grade of PDCs and the degree of overall peritumoural inflammatory reaction (0.05). PDC is a histological feature that predicts the aggressiveness of colorectal adenocarcinoma. Evaluation of PDC grade can better predict the biological behavior of colorectal cancer and more accurately guide the treatment and evaluate prognosis.

摘要

探讨大肠腺癌中低分化簇(PDCs)与临床病理参数的相关性及其临床病理意义。收集2017年1月至12月在南京医科大学附属南京医院(南京市第一医院)行根治性直肠结肠切除术的183例大肠腺癌病例。男性122例,女性61例,年龄42~89岁(平均68岁)。肿瘤直径2~14 cm(平均4.5 cm)。其中结肠癌124例,直肠癌59例。采用苏木精-伊红(H-E)染色评估大肠腺癌中PDCs的数量和分级。同时评估肿瘤周围总体炎症反应。分析PDCs与肿瘤分级、临床病理特征及大肠腺癌肿瘤周围总体炎症反应之间的关系。183例大肠腺癌中,104例(56.8%)可见PDCs,其中1级36例(19.7%),2级28例(15.3%),3级40例(21.9%)。PDCs与淋巴结转移、血管侵犯、分化程度、浸润深度及pTNM分期呈正相关(P<0.05)。结肠癌中PDCs的检出率高于直肠癌(P<0.05)。PDCs与年龄、性别、肿瘤大小及肿瘤周围总体炎症反应程度无关(P>0.05)。在临床病理参数中,PDCs分级与淋巴结转移和血管侵犯相关(有淋巴结转移和血管侵犯者高于无者,P<0.05);PDCs分级与年龄、肿瘤分化及pTNM分期呈正相关(P<0.05),与性别、肿瘤大小、肿瘤部位及浸润深度无显著差异(P>0.05)。PDCs分级与肿瘤周围总体炎症反应程度无关(P>0.05)。PDC是预测大肠腺癌侵袭性的一种组织学特征。评估PDC分级可更好地预测结肠癌的生物学行为,更准确地指导治疗及评估预后。

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