在新辅助疗法后,食道癌的组织学转移在活检和切除之间:一项试点研究
Tieying Hou1, Zhaohai Yang2, Qingzhao Zhang2
1Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
International journal of surgical pathology
|October 30, 2023
概括
新辅助疗法可以导致食道腺癌的组织学转变为神经内分泌瘤. 这种变化会影响预后,需要仔细的病理检查,以进行适当的患者管理.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 局部发达的食道腺癌通常接受新辅助疗法,然后进行切除.
- 在新辅助疗法后,从腺癌转变为神经内分泌瘤的组织学转变已被观察到.
- 这种组织学转变的机制和影响尚未得到充分理解.
研究的目的:
- 为了研究从食道腺癌转移到神经内分泌瘤后的组织学转移的现象后neoadjuvant治疗.
- 分析经历这种组织学变化的患者的临床特征和结果.
- 强调在治疗后样本中识别神经内分泌分化的重要性.
主要方法:
- 对11名局部晚期食道腺癌患者进行了回顾性审查,这些患者接受了新辅助治疗.
- 对活检和治疗后切除样本的分析.
- 组织病理学检查包括神经内分泌免疫标志物.
- 组织学发现与患者生存数据的相关性.
主要成果:
- 所有11名最初在活检上被诊断为腺癌的患者在切除样本中都显示出神经内分泌瘤.
- 八个切除包含了分化良好的神经内分泌新生瘤,三个包含神经内分泌癌瘤.
- 两个病例仅显示神经内分泌新生体,没有残留腺癌.
- 已故患者的中位生存期为26个月,五年生存率为11.3%.
结论:
- 新辅助疗法可以诱导食道腺癌中的神经内分泌瘤发生显著的组织学转变.
- 这个子组的预后似乎与传统的食道腺癌不同.
- 病理学家必须警神经内分泌形态的变化,因为这可能会影响治疗策略.
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