Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
J Clin Pathol. 2024 Mar 20;77(4):225-232. doi: 10.1136/jcp-2023-208803.
Colorectal cancer (CRC) is a common malignancy worldwide and tumour stage is closely related to clinical outcome. A small but significant proportion of submucosal-invasive (ie, pT1) CRC are associated with regional lymph node metastases (LNM) and a worse prognosis. The likelihood of LNM in pT1 CRC needs to be balanced against the operative risk and costs of surgical resection when determining the best patient management. A wide range of histopathological and clinical factors may affect LNM risk in this setting. This script provides a comprehensive overview of the tumour and patient-associated features that have been linked to LNM risk in pT1 CRC. Some of the features are well established within the literature and are included in published guidelines, while others are novel and emerging in nature. Odds ratios for LNM that are associated with key predictive features are provided where appropriate, and published models developed as an aid to the calculation of LNM risk are discussed.
结直肠癌(CRC)是一种常见的恶性肿瘤,肿瘤分期与临床结局密切相关。一小部分黏膜下浸润(即 pT1)的 CRC 与区域淋巴结转移(LNM)和预后较差有关。在确定最佳患者管理方案时,需要权衡 pT1 CRC 的 LNM 可能性与手术风险和手术切除的成本。广泛的组织病理学和临床因素可能会影响这种情况下的 LNM 风险。本脚本全面概述了与 pT1 CRC 中 LNM 风险相关的肿瘤和患者相关特征。其中一些特征在文献中已有充分的研究,并被纳入了已发表的指南中,而其他特征则是新颖的,正在不断涌现。本文提供了与关键预测特征相关的 LNM 的优势比,并讨论了为帮助计算 LNM 风险而开发的已发表模型。