Kobayashi Toshinori, Ishida Mitsuaki, Matsui Hiroshi, Uehara Hiroki, I Shoichiro, Yamada Norikazu, Igarashi Yuto, Hagiwara Chie, Mori Yoshihiro, Taniguchi Yohei, Saito Tomohito, Hino Haruaki, Hirose Yoshinobu, Murakawa Tomohiro, Watanabe Jun
Department of Colorectal Surgery, Kansai Medical University, 2-5-1, Shinmachi, Hirakata 573-1010, Japan.
Department of Pathology, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Japan.
Cancers (Basel). 2025 Feb 8;17(4):583. doi: 10.3390/cancers17040583.
Histopathological indicators, including desmoplastic reaction (DR) and tumour budding (TB), are significant prognostic indicators for metastatic liver lesions in patients with colorectal cancer (CRC). However, the relationship of DR and TB in primary CRC and metastatic lung lesions and their prognostic significance has not yet been examined. This study aimed to elucidate the association of DR and TB in primary CRC and metastatic lung lesions. Patients with pT3 or pT4 CRC with lung metastasis who underwent surgical resection of the primary CRC and synchronous or metachronous metastatic lung lesions were enrolled. DR was classified into immature (IM) and non-IM types, and TB was classified into TB1 (<4 buds), TB2 (5-9 buds) and TB3 (≥10 buds) in both the primary CRC and metastatic lung lesions. Overall, 40 patients with CRC (males, 21; females, 19; median age, 70 years; right-side colon, 6; left-side colon, 9; rectum, 25; pT3, 31; pT4, 9) were evaluated. Six and thirty-four patients were classified as having IM and non-IM DR in the metastatic lung lesions, respectively. Thirty-one, seven, and two patients were classified as having TB1, TB2, and TB3, respectively. There was no significant correlation between primary and lung metastatic lesions for DR ( = 0.08, = 0.086), whereas TB demonstrated a moderate correlation ( = 0.47, = 0.015). The presence of IM DR and TB2/3 in metastatic lung lesions significantly correlated with poor overall survival ( = 0.0020 and 0.044, respectively). histological indicators of metastatic lung lesions in CRC may provide important prognostic information for better patient care.
组织病理学指标，包括促纤维增生性反应（DR）和肿瘤芽生（TB），是结直肠癌（CRC）患者肝转移灶的重要预后指标。然而，原发性结直肠癌和肺转移灶中DR与TB的关系及其预后意义尚未得到研究。本研究旨在阐明原发性结直肠癌和肺转移灶中DR与TB的关联。纳入接受原发性结直肠癌手术切除及同期或异时性肺转移灶切除的pT3或pT4期伴有肺转移的CRC患者。在原发性结直肠癌和肺转移灶中，DR分为未成熟（IM）型和非IM型，TB分为TB1（<4个芽）、TB2（5 - 9个芽）和TB3（≥10个芽）。总共评估了40例CRC患者（男性21例，女性19例；中位年龄70岁；右半结肠6例，左半结肠9例，直肠25例；pT3 31例，pT4 9例）。肺转移灶中分别有6例和34例患者被分类为IM DR和非IM DR。分别有31例、7例和2例患者被分类为TB1、TB2和TB3。原发性和肺转移灶之间的DR无显著相关性（ = 0.08， = 0.086），而TB表现出中度相关性（ = 0.47， = 0.015）。肺转移灶中IM DR和TB2/3的存在与较差的总生存期显著相关（分别为 = 0.0020和0.044）。CRC肺转移灶的组织学指标可为更好地护理患者提供重要的预后信息。
