Sato Harunobu, Kotake Kenjiro, Maeda Kotaro, Kobayashi Hirotoshi, Takahashi Hiroshi, Sugihara Kenichi
Study Group for Peritoneal Metastasis from Colorectal Cancer by the Japanese Society for Cancer of the Colon and Rectum.
Department of Surgery, Fujita Health University, School of Medicine, Toyoake, Japan.
J Anus Rectum Colon. 2021 Oct 28;5(4):355-365. doi: 10.23922/jarc.2021-006. eCollection 2021.
This study aimed to explore the risk factors associated with cancer cell exfoliation in Stage II and III colorectal cancer (CRC).
This multicenter, prospective, observational study targeted 1,698 patients with cStage II and III CRC who underwent R0 resection between 2013 and 2017. Clinicopathological variables were analyzed for correlations with positive peritoneal lavage cytology (PLC).
The positive PLC rate was 2.7% (46/1,694 cases) at laparotomy and 1.6% (25/1,590 cases) after tumor resection. Logistic regression analyses identified that undifferentiated histologies diagnosed by preoperative biopsy specimen, cT4, and pN+ were independent factors that affected the positive PLC at laparotomy. The positive PLC rate at laparotomy was 4.5% (33/736 cases) among the patients with undifferentiated histology and/or cT4. Logistic regression analyses revealed that the presence of ascites and undifferentiated histology by biopsy independently affected positive PLC after tumor resection.
The undifferentiated histology and/or T4 indicated by preoperative diagnosis were identified as factors affecting PLC at laparotomy. Furthermore, ascites and preoperative histological type were identified as factors affecting positive PLC after tumor resection. As factors affecting positive PLC, these preoperative findings were found to be equivalent to pathological findings.
本研究旨在探讨Ⅱ期和Ⅲ期结直肠癌（CRC）癌细胞脱落的相关危险因素。
这项多中心、前瞻性观察性研究纳入了2013年至2017年间接受R0切除的1698例Ⅱ期和Ⅲ期CRC患者。分析临床病理变量与阳性腹腔灌洗细胞学检查（PLC）之间的相关性。
剖腹手术时阳性PLC率为2.7%（46/1694例），肿瘤切除后为1.6%（25/1590例）。Logistic回归分析确定，术前活检标本诊断为未分化组织学、cT4和pN+是影响剖腹手术时阳性PLC的独立因素。未分化组织学和/或cT4患者剖腹手术时阳性PLC率为4.5%（33/736例）。Logistic回归分析显示，腹水的存在和活检显示的未分化组织学独立影响肿瘤切除后的阳性PLC。
术前诊断显示的未分化组织学和/或T4被确定为影响剖腹手术时PLC的因素。此外，腹水和术前组织学类型被确定为影响肿瘤切除后阳性PLC的因素。作为影响阳性PLC的因素，这些术前发现与病理结果相当。
