结肠腺癌侵入自身肌肉的预后因素
John D Paulsen1, Alexandros D Polydorides
1Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
The American journal of surgical pathology
|June 15, 2023
概括
对于瘤侵入肌体自身 (pT2) 的结直肠癌患者来说,瘤芽,淋巴血管入侵和瘤大小等特定特征显著影响预后和治疗决策. 病理学家应仔细报告这些因素,以准确预测患者的预后.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 病理学 病理学 病理学
背景情况:
- 侵袭的深度 (pT阶段) 对结直肠癌的预后至关重要.
- 对涉及肌肉自身的pT2瘤的预后因素需要进一步调查.
研究的目的:
- 评估影响pT2结肠腺癌的临床行为的临床病理参数.
- 为了确定pT2瘤中疾病进展和淋巴结转移的预测因素.
主要方法:
- 对109名pT2结肠腺癌患者的回顾性分析.
- 使用了多变量分析,卡普兰-梅尔生存分析和考克斯回归.
- 评估了临床病理参数,包括侵袭深度,瘤大小,淋巴血管侵袭 (LVI),围神经侵袭 (PNI) 和瘤芽.
主要成果:
- 侵入外部肌肉自身 (pT2b) 的瘤与年龄较大,体型较大,LVI和更高的淋巴结阶段 (pN) 有关.
- 淋巴结转移的最强预测因素是LVI.
- 疾病进展与瘤大小>2.5厘米,PNI,高度瘤芽,更高的PN阶段和远程转移有关.
- 高度瘤芽独立预测了较短的无进展生存期,并且与pT2N0M0病例的疾病进展有关.
结论:
- 病理学家应该报告瘤大小,pT2a与pT2b入侵,LVI,PNI,尤其是pT2瘤的高等级瘤芽.
- 这些因素对于指导临床治疗决策和改善患者预后至关重要.
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