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结直肠癌中嗜银细胞的发生率及其预后意义

The prevalence and prognostic significance of argyrophil cells in colorectal carcinomas.

作者信息

Smith D M, Haggitt R C

出版信息

Am J Surg Pathol. 1984 Feb;8(2):123-8. doi: 10.1097/00000478-198402000-00006.

Abstract

The presence of argyrophil cells in the proliferative compartment of noncarcinoid carcinomas of the GI tract is well-documented; however, their prevalence and prognostic significance in colorectal carcinomas have never been systematically investigated and reported in the English literature. We applied the Churukian-Schenk argyrophil stain, a histochemical technique previously shown to be the most effective for demonstrating argyrophil cells, to 94 carcinomas of the colon and rectum from patients in whom a minimum 5-year follow-up was available. The 94 cases included 25 nonmucinous colonic and 25 nonmucinous rectal adenocarcinomas; 25 mucinous adenocarcinomas from all sites; and 19 undifferentiated carcinomas from all sites. Twenty control colorectal carcinoids all gave a positive argyrophil stain. Nineteen (20%) of the 94 carcinomas contained argyrophil cells as follows: adenocarcinoma of the colon, 52%; adenocarcinoma of the rectum, 16%; mucinous adenocarcinoma, 4%; and undifferentiated carcinoma, 5%. Crude 5-year survival rates were: carcinoids 80%; all carcinomas containing argyrophil cells, 37%; all without argyrophil cells, 27%. Chi-square between the later two groups was 0.723 (p less than 0.5). Because of the intrinsically poorer prognosis of mucinous and undifferentiated carcinomas, a comparison of survival rates was made excluding these tumors; chi-square was 0.095 (p less than 0.8). We conclude that argyrophil cells are commonly present in nonmucinous adenocarcinoma of the colon, but are less common in nonmucinous adenocarcinomas of the rectum and rare in mucinous and undifferentiated carcinomas. The presence of argyrophil cells did not influence prognosis in this series of cases.

摘要

胃肠道非类癌性癌增殖区中嗜银细胞的存在已有充分文献记载;然而,它们在结直肠癌中的发生率及预后意义从未在英文文献中得到系统研究和报道。我们将Churukian-Schenk嗜银染色法(一种先前已证明对显示嗜银细胞最有效的组织化学技术)应用于94例有至少5年随访资料的结肠和直肠癌患者。这94例病例包括25例非黏液性结肠腺癌和25例非黏液性直肠腺癌;25例来自所有部位的黏液腺癌;以及19例来自所有部位的未分化癌。20例对照性结肠类癌均呈嗜银染色阳性。94例癌中有19例(20%)含有嗜银细胞,情况如下:结肠腺癌,52%;直肠腺癌,16%;黏液腺癌,4%;未分化癌,5%。5年粗生存率为:类癌80%;所有含有嗜银细胞的癌,37%;所有不含嗜银细胞的癌,27%。后两组之间的卡方值为0.723(p小于0.5)。由于黏液性癌和未分化癌的预后本质上较差,因此在排除这些肿瘤后比较了生存率;卡方值为0.095(p小于0.8)。我们得出结论,嗜银细胞常见于结肠非黏液腺癌,但在直肠非黏液腺癌中较少见,在黏液腺癌和未分化癌中罕见。在这一系列病例中,嗜银细胞的存在不影响预后

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