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接受和未接受术前化疗的食管癌的组织病理学发现

Histopathological findings in oesophageal carcinoma with and without preoperative chemotherapy.

作者信息

Darnton S J, Allen S M, Edwards C W, Matthews H R

机构信息

Oesophageal Research Laboratory, East Birmingham Hospital.

出版信息

J Clin Pathol. 1993 Jan;46(1):51-5. doi: 10.1136/jcp.46.1.51.

DOI:10.1136/jcp.46.1.51
PMID:8432889
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC501114/
Abstract

AIMS

To investigate the pathological effects of preoperative chemotherapy on oesophageal carcinoma.

METHODS

Qualitative and quantitative changes in oesophageal carcinoma after preoperative chemotherapy were assessed by examination of biopsy specimens before treatment and resected specimens.

RESULTS

Of 13 patients with adenocarcinoma treated with 5-fluorouracil, adriamycin, and mitomycin (FAM), nine showed minor histological changes compared with 14 control cases. All 12 patients with squamous carcinoma treated with preoperative mitomycin, ifosfamide, and cisplatin (MIC) showed noticeable histological changes when compared with the 13 control cases. Changes included complete ablation (n = 1) and partial regression (n = 5) of the tumour. A quantitative estimate of the proportion of tumour to stroma showed no difference between control adenocarcinomas and those treated with chemotherapy. There was, however, a significant reduction (p < 0.01) in the proportion of tumour to stroma in the treated squamous group compared with the controls. There was no relation between the degree of response in squamous carcinomas and the degree of differentiation of the tumour. Patients in which squamous carcinomas responded well, as assessed quantitatively, showed a tendency to better survival at one year.

CONCLUSIONS

Histopathological changes attributable to chemotherapy can be observed in oesophageal carcinoma. The response of squamous carcinoma to MIC is histologically more evident than that of adenocarcinoma to FAM. A quantitative technique may be useful in assessing the effect of chemotherapy in oesophageal squamous carcinoma.

摘要

目的

探讨术前化疗对食管癌的病理影响。

方法

通过治疗前活检标本和切除标本的检查，评估术前化疗后食管癌的定性和定量变化。

结果

在13例接受氟尿嘧啶、阿霉素和丝裂霉素（FAM）治疗的腺癌患者中，与14例对照病例相比，9例显示轻微组织学变化。与13例对照病例相比，所有12例接受术前丝裂霉素、异环磷酰胺和顺铂（MIC）治疗的鳞癌患者均显示出明显的组织学变化。变化包括肿瘤完全消融（n = 1）和部分消退（n = 5）。肿瘤与基质比例的定量估计显示对照腺癌与化疗治疗的腺癌之间无差异。然而，与对照组相比，治疗的鳞癌组中肿瘤与基质的比例显著降低（p < 0.01）。鳞癌的反应程度与肿瘤的分化程度之间无相关性。定量评估显示鳞癌反应良好的患者在一年时有更好的生存趋势。

结论

食管癌中可观察到化疗引起的组织病理学变化。鳞癌对MIC的反应在组织学上比腺癌对FAM的反应更明显。定量技术可能有助于评估食管鳞癌化疗的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e1/501114/a7459cf3a0a5/jclinpath00427-0062-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e1/501114/2ad1273491a6/jclinpath00427-0061-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e1/501114/01bbb090d3f7/jclinpath00427-0061-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e1/501114/029433e10fbb/jclinpath00427-0062-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e1/501114/a7459cf3a0a5/jclinpath00427-0062-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e1/501114/2ad1273491a6/jclinpath00427-0061-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e1/501114/01bbb090d3f7/jclinpath00427-0061-b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e1/501114/029433e10fbb/jclinpath00427-0062-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e1/501114/a7459cf3a0a5/jclinpath00427-0062-b.jpg

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