周围神经侵袭作为联合肝细胞 - 胆管癌的预后决定因素:一个多中心病理学研究
Han Wang1, Ying-Ying Zhou2, Hong-Zhen Chen3
1Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Yangpu, Shanghai, China; Department of Pathology, Changhai Hospital, Naval Medical University, Yangpu, Shanghai, China.
概括
周围神经侵袭 (PNI) 是早期复发和联合肝细胞胆管癌 (cHCC-CCA) 低生存率的重要独立风险因素. 标准化PNI报告可以改善患者的预后分层.
科学领域:
- 肝胆道手术 肝胆道手术
- 手术病理学手术病理学
- 在瘤学瘤学.
背景情况:
- 周围神经侵入 (PNI) 在结合性肝细胞胆管癌 (cHCC-CCA) 的预后意义尚未明确.
- 这项多中心研究旨在评估cHCC-CCA患者中PNI的发病率,模式和临床影响.
研究的目的:
- 评估cHCC-CCA中PNI的流行率和模式.
- 确定PNI的无复发生存期 (RFS) 和整体生存期 (OS) 的预后值.
- 确定PNI的预测因子,并评估术后辅助性转动脉化学栓塞 (PA-TACE) 的效果.
主要方法:
- 三位病理学家对307名接受治疗性肝切除术的cHCC-CCA患者进行PNI的组织病理学评估.
- 使用卡普兰-梅尔和考克斯回归分析生存结果 (RFS,OS,早期/晚期RFS).
- 后勤回归用于识别PNI预测因素并评估PA-TACE的影响.
主要成果:
- 在16.0%的患者中存在PNI,与显著恶化的RFS和OS相关.
- 在PNI阳性患者中,早期复发明显高,而晚期复发没有差异.
- PNI是RFS,OS和早期RFS的独立风险因素;高性酸酶,大血管侵袭,微血管侵袭和缺席的瘤囊预测了PNI.
结论:
- 在cHCC-CCA中,PNI是一个关键的病理特征,独立地与早期复发和较差的存活率有关.
- PNI提出了重大的治疗挑战,强调了其准确报告的必要性.
- 关于PNI状态的标准化病理报告对于改善cHCC-CCA管理中的预后分层至关重要.
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