Jiang Yangyang, Liu Ling, Chang Yingying, Gu Limei, Wang Yaohui, Ling Ting-Sheng, Zhang Xiaolong
Nanjing University of Chinese Medicine, Nanjing, 210029, Jiangsu Province, China.
Institute of Digestive Endoscopy Center, Institute of Digestive Endoscopy Center, Taixing People's Hospital, Taizhou, 225400, Jiangsu Province, China.
Discov Oncol. 2025 Aug 18;16(1):1581. doi: 10.1007/s12672-025-03211-w.
This study aimed to explore the distribution of Ezrin-positive cells in poorly differentiated cluster (PDC) of colorectal cancer (CRC), and its correlation with both traditional and auxiliary pathological indicators, including E-cadherin and tumor-stroma ratio (TSR), as well as patient prognosis.
We selected 59 patients with stage I-III who underwent radical surgery to observe the expression of CRC under hematoxylin and eosin (H&E) and immunohistochemistry (IHC) staining. This study establishes the poorly differentiated cluster-based Ezrin marginal score (PDC-EMS), which quantifies the tendency of Ezrin-positive cells to accumulate at the margins of PDC, to evaluate the validity and superiority of this assessment method.
The results indicate that PDC grading is significantly correlated with the TNM stage, pN stage, macroscopic configuration, and tumor budding (TB) grading. The PDC-EMS shows significant correlations with PDC and TB grading and demonstrates good consistency with traditional pathological indicators. E-cadherin expression significantly negatively correlates with TNM staging and markedly associates with pN stage, perineural invasion (PNI) and TSR. Univariate analysis suggests that the PDC-EMS system, PDC grading (three-tiered system) and pT stage are risk factors that affect prognosis. Multivariate regression analysis identifies WHO grading, E-cadherin, and tumor location to be independent influencing factors. When considering only PDC classification, pT stage, and lympho-vascular invasion (LVI), PDC emerges an independent influencing factor affecting postoperative survival.
The innovative PDC-EMS scoring system developed in this study demonstrates functional consistency with both PDC grading and TB grading. Furthermore, this scoring system offers significant advantages in predicting prognosis and shows promising potential for clinical applications.
本研究旨在探讨埃兹蛋白（Ezrin）阳性细胞在结直肠癌（CRC）低分化簇（PDC）中的分布情况，及其与包括E-钙黏蛋白和肿瘤间质比（TSR）在内的传统及辅助病理指标的相关性，以及与患者预后的关系。
我们选取了59例接受根治性手术的I-III期患者，通过苏木精-伊红（H&E）染色和免疫组织化学（IHC）染色观察CRC的表达情况。本研究建立了基于低分化簇的埃兹蛋白边缘评分（PDC-EMS），该评分量化了埃兹蛋白阳性细胞在PDC边缘积聚的趋势，以评估该评估方法的有效性和优越性。
结果表明，PDC分级与TNM分期、pN分期、大体形态及肿瘤芽生（TB）分级显著相关。PDC-EMS与PDC及TB分级显著相关，且与传统病理指标具有良好的一致性。E-钙黏蛋白表达与TNM分期显著负相关，与pN分期、神经侵犯（PNI）和TSR显著相关。单因素分析表明，PDC-EMS系统、PDC分级（三级系统）和pT分期是影响预后的危险因素。多因素回归分析确定WHO分级、E-钙黏蛋白和肿瘤位置为独立影响因素。仅考虑PDC分类、pT分期和淋巴管侵犯（LVI）时，PDC是影响术后生存的独立影响因素。
本研究开发的创新性PDC-EMS评分系统与PDC分级和TB分级具有功能一致性。此外，该评分系统在预测预后方面具有显著优势，具有良好的临床应用潜力。
