Wolmark N, Fisher E R, Wieand H S, Fisher B
Cancer. 1984 Jun 15;53(12):2707-12. doi: 10.1002/1097-0142(19840615)53:12<2707::aid-cncr2820531225>3.0.co;2-r.
This study examines the interrelationships of depth of penetration, tumor size, and the number of positive nodes in Dukes C colorectal cancer. The results indicated that depth of tumor penetration was related to both tumor size and the number of positive regional lymph nodes. Tumors with positive nodes which failed to penetrate the muscularis propria (C1) were smaller, and were associated with fewer positive nodes than were tumors penetrating all coats of the bowel (C2). Although tumor penetration was related to tumor size and the number of positive nodes, no correlation was evident between tumor size and the number of positive nodes within the C1 and C2 patient subsets. The data underscore the biological significance of depth of tumor penetration and militate against tumor size as a prognostic discriminant in patients with colorectal cancer. The findings represent a contradiction to the prevailing biological concepts relative to the behavior of solid tumors as reflected in the TNM classification scheme.
本研究探讨了 Dukes C 期结肠癌的浸润深度、肿瘤大小及阳性淋巴结数量之间的相互关系。结果表明，肿瘤浸润深度与肿瘤大小及区域阳性淋巴结数量均相关。未穿透固有肌层的伴有阳性淋巴结的肿瘤（C1 期）比穿透肠壁全层的肿瘤（C2 期）更小，且阳性淋巴结数量更少。虽然肿瘤浸润与肿瘤大小及阳性淋巴结数量相关，但在 C1 期和 C2 期患者亚组中，肿瘤大小与阳性淋巴结数量之间无明显相关性。这些数据强调了肿瘤浸润深度的生物学意义，反对将肿瘤大小作为结肠癌患者预后的判别指标。这些发现与 TNM 分类系统所反映的关于实体瘤行为的主流生物学概念相矛盾。
