Talbot I C, Ritchie S, Leighton M, Hughes A O, Bussey H J, Morson B C
Histopathology. 1981 Mar;5(2):141-63. doi: 10.1111/j.1365-2559.1981.tb01774.x.
Histopathological material from operation specimens of rectal adenocarcinoma was reviewed and invasion of veins identified in 51.9% of 703 cases. The extent of venous invasion, thickness of the walls of invaded veins and various other histological features were examined in detail. By follow-up studies recurrence rates, incidence of distant metastases and corrected 5-year survival rates were obtained; correlation with the histopathological results showed that invasion of extramural and thick-walled veins is associated with a poor prognosis independent of the degree of differentiation of the adenocarcinoma. Prognosis is not significantly related to the presence of necrosis of intravenous tumour and a clearly defined stroma in the intravenous growth all appear to exert a protective influence on patient survival. Whereas permeation of capillaries in vein walls, the presence of loose clumps of tumour cells in veins and direct contact between tumour cells and venous blood appear to adversely affect survival. Venous invasion is shown to be related to local invasiveness of rectal carcinoma. Suggested modes of venous spread and interaction with host tissues are proposed, with implications for general attitudes to the spread of cancer and metastasis.
对703例直肠腺癌手术标本的组织病理学材料进行了回顾，发现其中51.9%的病例存在静脉侵犯。详细检查了静脉侵犯的程度、被侵犯静脉壁的厚度以及各种其他组织学特征。通过随访研究得出复发率、远处转移发生率和校正后的5年生存率；与组织病理学结果的相关性表明，壁外和厚壁静脉侵犯与预后不良相关，而与腺癌的分化程度无关。预后与静脉内肿瘤坏死的存在无显著相关性，静脉内生长中明确界定的基质似乎对患者生存具有保护作用。而静脉壁内毛细血管的浸润、静脉内肿瘤细胞松散团块的存在以及肿瘤细胞与静脉血的直接接触似乎对生存产生不利影响。静脉侵犯与直肠癌的局部侵袭性有关。提出了静脉扩散的建议模式以及与宿主组织的相互作用，并对癌症扩散和转移的一般观念产生影响。
