瘤芽对结直肠癌辅助化疗的影响
Hao Xie1,2,3,4, Ziwei Zeng1,2,3, Yujie Hou1,2,3
1Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
BJS open
|January 8, 2024
概括
大肠直肠癌患者的高瘤芽表明生存率不佳. 辅助化疗有利于那些芽率高的人 (Bd3),除非淋巴细胞透率也很高.
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:
- 高瘤芽是对结直肠癌患者生存率低下的已知的危险因素.
- 了解瘤芽等级的预后影响和辅助化疗的作用对于优化患者的治疗结果至关重要.
研究的目的:
- 调查瘤芽等级对结肠直肠癌无疾病和整体存活率的影响.
- 为了评估辅助化疗在不同瘤芽等级的有效性.
主要方法:
- 对412名经过彻底手术的结直肠癌患者进行了回顾性分析.
- 使用国际瘤芽共识会议 (ITBCC) 关于H&E染色幻灯片的指导方针进行瘤芽评估.
- 瘤芽度与生存结果和对辅助化疗的反应的相关性,包括对淋巴细胞透的亚组分析.
主要成果:
- 瘤芽等级 (Bd1,Bd2,Bd3) 与5年无病生存率 (82.9%,70.1%,49.3%) 和整体生存率 (90%,79.5%,62.7%) 有显著的相关性.
- 辅助化疗显著改善了芽率高 (Bd3) 的患者的生存率,但没有改善芽率低 (Bd1) 或中等 (Bd2) 的患者的生存率.
- 在Bd3患者中,在淋巴细胞透率低但透率高的患者中观察到辅助化疗的益处.
结论:
- 高瘤芽率 (Bd3) 是结直肠癌中生存率较差的强有力的预测因素.
- 辅助化疗对高瘤芽率 (Bd3) 的患者,特别是那些没有高淋巴细胞透率的患者提供了生存益处.
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