食道腺癌中不连续生长模式的临床意义和预后影响:一项多机构研究
Michel Kmeid1, Goo Lee2, Zhaohai Yang3
1Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY.
The American journal of surgical pathology
|January 19, 2024
概括
在食道腺癌 (EAC) 中,不连续的瘤生长 (DG) 与较差的结果有关. 在EAC中识别DG对于准确的分期和改善患者生存预测至关重要.
科学领域:
- 在瘤学瘤学.
- 手术病理学手术病理学
背景情况:
- 不连续增长 (DG),包括瘤沉积物和内转移,是食道腺癌 (EAC) 中鲜为人知的现象.
- 在未接受过治疗和接受过治疗的EAC患者中,DG的临床意义仍然不清楚.
研究的目的:
- 调查食道腺癌 (EAC) 中不连续生长 (DG) 的患病率和临床病理学意义.
- 确定DG是否是EAC患者瘤结果的独立预测因素.
主要方法:
- 从151名未接受过治疗的EAC患者和121名接受过治疗的EAC患者的食道切除样本进行了回顾性审查.
- DG被定义为分离的瘤焦点 (距离主要瘤≥2毫米) 在粘膜下,肌肉自身或周围组织中.
- 临床病理参数和瘤结局在具有和没有DG的瘤之间进行了比较.
主要成果:
- 在16%的未经治疗的EAC病例和29%的经过治疗的EAC病例中发现了DG.
- 在未经治疗的EAC中,DG与较大的瘤大小,更高的等级/阶段以及增加的不良特征有关.
- 在接受治疗的EAC中,DG与更高的TNM阶段和更频繁的淋巴血管/周围神经扩散以及正边缘相关.
- 多变量分析证实DG是所有EAC患者生存的独立不良预测因子.
结论:
- 食道腺癌 (EAC) 的不连续增长 (DG) 与不良的临床病理特征有关.
- 在未接受治疗和接受治疗的EAC中,DG是较差生存结果的独立预测因素.
- 应该将GD纳入EAC的临床病理评估和未来的分期系统.
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