Krasna M J, Flancbaum L, Cody R P, Shneibaum S, Ben Ari G
Department of Surgery, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick 08903.
Cancer. 1988 Mar 1;61(5):1018-23. doi: 10.1002/1097-0142(19880301)61:5<1018::aid-cncr2820610527>3.0.co;2-h.
The incidence and significance of histologic vascular and/or neural invasion in 77 patients with colorectal carcinoma treated over a 6-year period were analyzed retrospectively. Vascular invasion was found in 37.6% of patients and neural invasion in 14.3%. The following three types of vascular invasion were identified: tumor lining epithelium, tumor thrombi, and destruction of the vessel wall. The incidence of metastases in patients with vascular invasion was 60% as opposed to 17% in those without vascular invasions (P less than 0.0001). Survival in these patients was 29.7% and 62.2%, respectively (P less than 0.003). Metastases were found in 72.7% of patients with neural invasion, as opposed to 27% of those without neural invasion (P less than 0.01). Survival was 29.6% as opposed to 57.7% in those without neural invasion (P less than 0.003). Even among patients in the same Dukes' stage, prognosis, as determined by incidence of recurrence, metastases, and survival, was worse significantly among those patients demonstrating vascular invasion (P less than 0.03). Examination of patients with colorectal carcinoma for the presence of vascular and neural invasion may provide useful information for determining future treatment and prognosis.
回顾性分析了6年间接受治疗的77例结肠直肠癌患者组织学血管和/或神经侵犯的发生率及意义。37.6%的患者发现有血管侵犯，14.3%的患者有神经侵犯。确定了以下三种血管侵犯类型：肿瘤衬里上皮、肿瘤血栓和血管壁破坏。有血管侵犯患者的转移发生率为60%，而无血管侵犯患者为17%（P<0.0001）。这些患者的生存率分别为29.7%和62.2%（P<0.003）。有神经侵犯患者的转移发生率为72.7%，而无神经侵犯患者为27%（P<0.01）。有神经侵犯患者的生存率为29.6%，无神经侵犯患者为57.7%（P<0.003）。即使在相同Dukes分期的患者中，根据复发、转移发生率和生存率确定的预后，在有血管侵犯的患者中也明显更差（P<0.03）。检查结肠直肠癌患者有无血管和神经侵犯可为确定未来治疗和预后提供有用信息。
