年轻人与老年患有第三期结肠癌的患者的淋巴扩散模式
Jihyung Song1, Kozo Kataoka1, Manabu Inoue2
1Division of Lower GI, Department of Gastroenterological Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan.
BJS open
|May 31, 2024
概括
患有第三阶段结肠癌的年轻患者表现出更多的淋巴结扩散和更高的中枢淋巴结入侵风险,这表明疾病更具侵略性. 中枢淋巴结入侵是这个群体无复发生存的不良预后因素.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 第三阶段结肠癌的淋巴结传播模式在年轻患者和老年患者之间有所不同.
- 这种与淋巴结转移的年龄相关差异尚未得到充分理解.
- 研究这些模式对于理解疾病生物学和预后至关重要.
研究的目的:
- 为了比较淋巴结的扩散模式在年轻人与老年患者与第三阶段结肠癌.
- 评估淋巴结参与对生存结果的预后影响.
- 为了确定中枢淋巴结状况是否基于年龄有差异性预后价值.
主要方法:
- 对接受D3淋巴切除术的第三阶段结肠癌患者 (年轻人:≤45岁,老年人:≥80岁) 的回顾性分析.
- 在不同年龄组之间比较总收获和入侵的淋巴结数量.
- 评估中枢淋巴结的阳性及其与无复发和整体存活率的关联.
主要成果:
- 与老年患者相比,年轻患者的淋巴结被摘除的数量显著更多,感染淋巴结的数量也更高.
- 阳性中枢淋巴结的比例在年轻患者 (9.52%) 和老年患者 (4.59%) 中显著高.
- 中枢淋巴结入侵是年轻患者无复发生存的显著不良预后因素 (HR 5.21) 但不是老年患者 (HR 1.73).
结论:
- 患有第三期结肠癌的年轻患者表现出更具侵略性的疾病模式,淋巴结转移的增加.
- 中枢淋巴结的侵袭是 III 期结肠癌较年轻患者预后不佳的关键指标.
- 年龄是影响淋巴结扩散和第三阶段结肠癌的预后影响的一个重要因素.
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