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结直肠癌:一种复杂疾病的简要分析

Colorectal Cancer: A Brief and Simplified Analysis of a Complex Disease.

作者信息

Petrov Krasimir, Ivanov Ivan, Popovska Savelina, Betova Tatyana, Kamburova Zornitsa

机构信息

Department of Pathology, Faculty of Medicine, Medical University, 5800 Pleven, Bulgaria.

Department of General and Clinical Pathology, University Multi-profile Hospital for Active Treatment "Georgi Stranski", 5800 Pleven, Bulgaria.

出版信息

Medicina (Kaunas). 2024 Dec 10;60(12):2034. doi: 10.3390/medicina60122034.

Abstract

This study examined factors influencing the onset and progression of colorectal tumors, including patients' epidemiological data, tumor location (right-sided, left-sided, and rectal), histomorphology, perineural or intraneural invasion, lymph node status, immune reactions, mismatch repair (MMR) status, and commonly observed mutations. Our primary goal was to evaluate their predictive and prognostic value and interactions. We analyzed a retrospective cohort of 100 patients with colorectal adenocarcinoma diagnosed between 2020 and 2023, using formalin-fixed paraffin-embedded (FFPE) tumor blocks. The methods included routine H&E microscopy, immunohistochemistry, Next-Generation Sequencing (NGS), and subsequent statistical analysis. The findings showed a median diagnosis age of 70 years, with no gender-specific tumor localization. Right-sided tumors were prevalent, especially among patients with a defective MMR (dMMR), which represented 89% of dMMR cases. MMR status significantly correlated with tumor localization. We observed significant relationships between tumor grade, lymphovascular invasion, and overall tumor stage. Higher tumor grades and stages correlated with increased lymphovascular invasion and lymph node involvement. Interestingly, tumor budding did not correlate with lymph node metastasis but was significantly associated with higher tumor grades. Most BRAF mutations were found in right-sided tumors, indicating a significant correlation with this localization. This study focuses on the diversity of colorectal cancer (CRC) by examining how genetic and histological characteristics vary based on tumor location or other tumor variables.

摘要

本研究调查了影响结直肠肿瘤发生和进展的因素,包括患者的流行病学数据、肿瘤位置(右侧、左侧和直肠)、组织形态学、神经周围或神经内浸润、淋巴结状态、免疫反应、错配修复(MMR)状态以及常见的突变情况。我们的主要目标是评估它们的预测和预后价值以及相互作用。我们分析了一个回顾性队列,该队列由2020年至2023年间诊断为结直肠腺癌的100例患者组成,使用福尔马林固定石蜡包埋(FFPE)肿瘤组织块。方法包括常规苏木精-伊红(H&E)显微镜检查、免疫组织化学、二代测序(NGS)以及后续的统计分析。研究结果显示,诊断时的中位年龄为70岁,肿瘤定位无性别差异。右侧肿瘤较为常见,尤其是在错配修复缺陷(dMMR)患者中,dMMR患者占比达89%。MMR状态与肿瘤定位显著相关。我们观察到肿瘤分级、淋巴管浸润与肿瘤总体分期之间存在显著关系。较高的肿瘤分级和分期与淋巴管浸润增加及淋巴结受累相关。有趣的是,肿瘤芽生与淋巴结转移无关,但与较高的肿瘤分级显著相关。大多数BRAF突变见于右侧肿瘤,表明与该定位存在显著相关性。本研究通过检查遗传和组织学特征如何根据肿瘤位置或其他肿瘤变量而变化,聚焦于结直肠癌(CRC)的多样性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f185/11727892/62e205f555fb/medicina-60-02034-g001.jpg

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