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[结直肠癌的组织形态学和分子病理学预后因素]

[Histomorphological and molecular-pathological prognostic factors in colorectal cancer].

作者信息

Erlenbach-Wünsch K

机构信息

Pathologisches Institut, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland.

出版信息

Pathologe. 2020 Dec;41(Suppl 2):70-75. doi: 10.1007/s00292-020-00880-y. Epub 2020 Dec 15.

Abstract

Colorectal carcinomas are the second most common cancer and cause of cancer death in Germany for both men and women. Different aspects of morphological, immunohistochemical, and molecular pathological prognostic factors of colorectal carcinomas and their precursors were investigated. We demonstrated the prognostic relevance and importance of a precise classification of pericolonic tumor deposits (PTDs) in the pT category of the TNM classification. Furthermore, we demonstrated that patients with regional lymph node metastases after neoadjuvant chemoradiotherapy (nCRT) in rectal carcinomas with ypN0 status do not have a worse prognosis than patients without signs of preoperative lymph node metastases.Molecular pathological examinations of so-called serrated colorectal fibroblastic polyps as possible precursor lesions of colorectal carcinomas showed that their epithelial area represents a true neoplastic component and thus allows for their consideration in the context of a risk assessment for colorectal carcinomas.

摘要

在德国,结直肠癌是第二大常见癌症,也是男性和女性癌症死亡的第二大原因。研究了结直肠癌及其癌前病变在形态学、免疫组织化学和分子病理学方面不同的预后因素。我们证明了在TNM分类的pT类别中,结肠周围肿瘤沉积物(PTD)的精确分类具有预后相关性和重要性。此外,我们还证明,新辅助放化疗(nCRT)后出现区域淋巴结转移但ypN0状态的直肠癌患者,其预后并不比术前无淋巴结转移迹象的患者差。对所谓的锯齿状结直肠成纤维细胞息肉进行分子病理学检查,作为结直肠癌可能的癌前病变,结果显示其上皮区域代表真正的肿瘤成分,因此在结直肠癌风险评估中可予以考虑。

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