Zhang Y L, He H J, Cheng J, Shen D H
Department of Pathology, Peking University People's Hospital, Beijing 100044, China.
Department of Radiology, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Bing Li Xue Za Zhi. 2021 Jan 8;50(1):26-31. doi: 10.3760/cma.j.cn112151-20200405-00290.
To investigate the value of histopathological growth patterns (HGP) in predicting the 3-year progression free survival (PFS) after resection the liver metastasis from patients with colorectal cancer. The clinicopathological data of the 111 patients with liver metastasis of colorectal cancer diagnosed at Peking University People's Hospital, Beijing, China from January 2007 to January 2017 were analyzed. After excluding the patients who did not meet the inclusion criteria, a total of 80 patients were analyzed. According to the international expert consensus on HGP, the HGP types of liver metastasis were evaluated. The correlation between HGP and other clinicopathological factors was analyzed using χ or Fisher test. Kaplan-Meier survival curve was used to examine 3-year PFS in the patients with liver metastasis of colorectal cancer by HGP. The independent risk factors of 3-year post-resection PFS were determined using univariable and multivariable analyses. A total of 80 cases were analyzed, including 43 cases of desmoplastic type (54%), 32 cases of replacement type (40%), 3 cases of pushing type (4%), and 2 cases of mixed type (2%). There was no correlation of HGP with age, gender, time of metastasis, tumor burden, histological grade, mucous differentiation or microsatellite instability. The 3-year post-resection PFS of the patients with desmoplastic type was significantly longer than that of patients with replacement type. The univariable and multivariable analyses showed that HGP was an independent prognostic factor. The HGP of colorectal cancer metastases to the liver mainly present as desmoplastic and replacement types. HGP is an independent prognostic factor for the patients with liver metastasis of colorectal cancer after resection of the metastasis. Therefore, HGP should be clearly indicated in the pathological report to help guide clinical treatments.
探讨组织病理学生长模式（HGP）在预测结直肠癌患者肝转移切除术后3年无进展生存期（PFS）中的价值。分析了2007年1月至2017年1月在中国北京北京大学人民医院诊断为结直肠癌肝转移的111例患者的临床病理资料。排除不符合纳入标准的患者后，共分析80例患者。根据关于HGP的国际专家共识，评估肝转移的HGP类型。采用χ²检验或Fisher检验分析HGP与其他临床病理因素之间的相关性。采用Kaplan-Meier生存曲线按HGP检查结直肠癌肝转移患者的3年PFS。采用单因素和多因素分析确定切除术后3年PFS的独立危险因素。共分析80例病例，包括促纤维组织增生型43例（54%）、替代型32例（40%）、推挤型3例（4%）和混合型2例（2%）。HGP与年龄、性别、转移时间、肿瘤负荷、组织学分级、黏液分化或微卫星不稳定性无关。促纤维组织增生型患者切除术后3年PFS显著长于替代型患者。单因素和多因素分析显示HGP是独立的预后因素。结直肠癌肝转移的HGP主要表现为促纤维组织增生型和替代型。HGP是结直肠癌肝转移患者切除转移灶后独立的预后因素。因此，病理报告中应明确指出HGP以帮助指导临床治疗。
