淋巴结内存在血吸虫卵可预测血吸虫性结直肠癌的不良预后。

Presence of schistosome eggs in lymph node predict unfavorable prognosis in schistosomal colorectal cancer.

机构信息

Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China.

出版信息

Eur J Cancer Prev. 2023 Nov 1;32(6):566-574. doi: 10.1097/CEJ.0000000000000811. Epub 2023 May 3.

DOI:10.1097/CEJ.0000000000000811

PMID:37200090

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10538618/

Abstract

OBJECTIVE

The purpose of this study was to investigate the prognostic significance of schistosome eggs' location in schistosomal colorectal cancer (SCRC).

METHODS

172 cases of SCRC were retrospectively analyzed. Patient clinicopathological parameters and survival rates were analyzed.

RESULTS

There were 102 males and 70 females, the median age was 71 years (range, 44-91). All patients were followed, and the median time was 50.1 months (range, 1.0-79.7). There were 87 patients with PS1 (presence site 1, eggs deposited in the mucosa) and 85 patients with PS2 (presence site 2, eggs deposited in the muscularis propria or throughout the full thickness of the intestinal wall), 159 patients presented with eggs in cutting edge and 83 patients presented with eggs in lymph node (LN). Hepatic schistosomiasis was found in 27.3% of patients by imaging modalities and correlated to patients with PS2 ( P < 0.001) and LNs' eggs ( P < 0.001). Survival analyses showed that in stage III SCRC, eggs' presence in LN associated with worse DFS ( P = 0.004) or marginally worse OS ( P = 0.056), patients with PS2 had shorter OS ( P = 0.044). Multivariate analyses revealed hepatic schistosomiasis was an independent prognostic factor for DFS and OS in stage III SCRC ( P = 0.001, 0.002, respectively). In adjusted multivariate analysis, eggs' presence in LN was an independent prognostic factor for DFS in stage III SCRC ( P = 0.006).

CONCLUSIONS

In stage III SCRC, eggs' presence in LN could predict poor prognosis and hepatic schistosomiasis was an independently unfavorable prognosis factor.

摘要

目的

本研究旨在探讨血吸虫卵在血吸虫性结直肠癌（SCRC）中的位置对预后的意义。

方法

回顾性分析 172 例 SCRC 患者的临床病理参数和生存率。

结果

男性 102 例，女性 70 例，中位年龄 71 岁（范围，44-91 岁）。所有患者均获得随访，中位时间为 50.1 个月（范围，1.0-79.7）。PS1 组 87 例（部位 1，卵沉积在黏膜），PS2 组 85 例（部位 2，卵沉积在固有肌层或整个肠壁全层），159 例切缘有卵，83 例淋巴结有卵。影像学检查发现 27.3%的患者有肝血吸虫病，与 PS2 （P<0.001）和淋巴结卵（P<0.001）有关。生存分析显示，在 III 期 SCRC 中，淋巴结有卵与无病生存期（DFS）（P=0.004）或总生存期（OS）（P=0.056）较差相关，PS2 患者 OS 较短（P=0.044）。多因素分析显示，肝血吸虫病是 III 期 SCRC 的 DFS 和 OS 的独立预后因素（P=0.001，0.002）。在调整后的多因素分析中，淋巴结有卵是 III 期 SCRC 的 DFS 的独立预后因素（P=0.006）。