Pennings Alexander J, van der Velden Brecht A, Kloft Maximilian, Kooreman Loes F S, Kleijnen Jos M P, Breukink Stephanie O, Beets Geerard L, Grabsch Heike I, Melenhorst Jarno
From the Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.
GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands.
Ann Surg Open. 2023 Nov 6;4(4):e336. doi: 10.1097/AS9.0000000000000336. eCollection 2023 Dec.
In this review, we aim to provide an overview of literature on lymph node (LN) histomorphological features and their relationship with the prognosis in colorectal cancer (CRC).
Lymph nodes play a crucial role in the treatment and prognosis of CRC. The presence of LN metastases considerably worsens the prognosis in CRC patients. Literature has shown that the total number of LNs and the number negative LNs (LNnegs) has prognostic value in CRC patients. In esophageal carcinoma, LN size seems to be surrogate of the host antitumor response and a potentially clinically useful new prognostic biomarker for (y)pN0 esophageal carcinoma.
A comprehensive search was performed in Pubmed, Embase, Medline, CINAHL, and the Cochrane library in March 2021. The PRISMA guidelines were followed. Only studies focusing on histomorphological features and LN size and their relation to overall survival were selected.
A total of 9 unique articles met all inclusion criteria and were therefore included in this systematic review. Six of these studies investigated HMF (eg, paracortical hyperplasia, germinal center predominance, and sinus histiocytosis) and 4 studies LNneg size and their relationship with overall survival. The presence of paracortical hyperplasia and an increased number of large LNnegs is related to a more favorable prognosis in CRC.
The results of this systematic review seem to support the hypothesis that there is a relationship between the host antitumor response reflected in different histomorphological reaction patterns visible in LNnegs and LNneg size related to survival in CRC patients.
在本综述中，我们旨在概述有关淋巴结（LN）组织形态学特征及其与结直肠癌（CRC）预后关系的文献。
淋巴结在CRC的治疗和预后中起着关键作用。LN转移的存在会显著恶化CRC患者的预后。文献表明，LN的总数和阴性LN（LNnegs）的数量对CRC患者具有预后价值。在食管癌中，LN大小似乎是宿主抗肿瘤反应的替代指标，也是（y）pN0食管癌潜在的临床有用新预后生物标志物。
2021年3月在Pubmed、Embase、Medline、CINAHL和Cochrane图书馆进行了全面检索。遵循PRISMA指南。仅选择关注组织形态学特征、LN大小及其与总生存关系的研究。
共有9篇独特的文章符合所有纳入标准，因此被纳入本系统综述。其中6项研究调查了组织形态学特征（如副皮质增生、生发中心优势和窦组织细胞增生），4项研究了LNneg大小及其与总生存的关系。副皮质增生的存在和大量LNnegs数量的增加与CRC更有利的预后相关。
本系统综述的结果似乎支持这样一种假设，即在LNnegs中可见的不同组织形态学反应模式所反映的宿主抗肿瘤反应与CRC患者生存相关的LNneg大小之间存在关联。
