在局部晚期食道癌症中的瘤沉积:重新定义手术切除后的TNM分期和预后影响
Fan Zhang1, Zhen-Hua Li1, Ke-Qin Dong2
1Department of thoracic Surgery, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
概括
瘤沉积 (TDs) 在食道癌 (ESCA) 与更差的预后相关. 在分期中包括TD可以提高患者预测结果的准确性.
科学领域:
- 癌症学
- 外科病理学
背景情况:
- 瘤沉积 (TD) 或癌症结节是脂肪组织中瘤细胞的积累,在结肠直肠癌和现在的食道癌症 (ESCA) 中观察到.
- 尽管有一些证据将其与较差的结果联系起来,但在ESCA中,TD的预后和分期影响尚未完全理解.
研究的目的:
- 在食道癌 (ESCA) 中研究瘤沉积 (TD) 的预后意义.
- 评估TD对ESCA的TNM分阶段系统的影响.
主要方法:
- 对经过食道切除的482名ESCA患者 (2014 - 2022年) 的回顾性分析.
- 根据手术后的样本,患者被分为瘤沉积阳性 (TDP) 和瘤沉积阴性 (TDN).
- 对比了临床病理特征和生存结果;考克斯回归模型评估了预后意义和TNM分期影响.
主要成果:
- 在482名患者中 (TNM阶段III-IV),有10. 2%的患者是TDP,有89. 8%的患者是TDN.
- 在整个队列和TNM阶段III和IV分组中,TDP组的预后明显差于TDN组.
- 在每个N阶段的小组中,TDP始终显示出较差的结果,TNM III阶段的TDP和TNM IV阶段的TDN患者之间没有显著差异.
结论:
- 瘤沉积 (TDs) 是食道癌 (ESCA) 副作用的独立危险因素.
- 在ESCA患者中,TD的存在与预后较差有关.
- 建议在未来的TNM分期系统更新中包括TD,以提高预后准确性.
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