在新辅助化疗后的病态淋巴结回归预测了食道腺癌的复发和生存:英国的一项多中心研究
Jonathan L Moore1,2, Michael Green3, Aida Santaolalla2
1Department of Upper Gastrointestinal and General Surgery, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom.
概括
在新辅助化疗后的病态淋巴结 (LN) 回归是食道腺癌中生存的强有力的预测因素. 评估LN反应可以提高诊断准确度,超越TNM分期和原发性瘤回归.
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:
- 有限的证据存在于淋巴结 (LN) 回归后的预后影响为食道腺癌的新辅助化疗.
- 目前还没有对LN响应的标准化定义.
研究的目的:
- 评估LN回归对食道腺癌手术切除后患者存活率的影响.
- 为了确定新辅助化疗后LN回归的预后意义.
主要方法:
- 一项多中心队列研究,涉及食管腺癌患者,接受新辅助化疗和手术治疗.
- 在食道切除术中检索的淋巴结 (LNs) 被评估为化疗反应,使用定义的LN回归得分 (LNRS).
- 使用考克斯回归进行了生存分析,以初级瘤回归进行调整,并评估了辨别能力.
主要成果:
- 对763名患者的17930个LN的分析揭示了不同的LN反应类别:完全,部分,差/无反应和LN负.
- 完整的LN响应,部分LN响应和LN负状态与较差/无LN响应相比,与显著降低的死亡率有关.
- 在21.9%的患者中观察到原发性瘤回归和LN回归之间的不一致.
结论:
- 病理性LN回归是食道腺癌的强有力的预后因素,提供了超越标准病理性TNM分期和原发性瘤回归的宝贵信息.
- 应将LN回归评估纳入食道切除样本的常规病理报告.
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