病理学参数对Ⅱ期结直肠癌术后患者预后评估的价值  

Value of pathological parameters in assessing prognosis of patients receiving surgery for stage Ⅱ colorectal cancer

作　　者：张兴琼[1] 张敬麟 杨媛 袁远洪 钟寒迪[1] 吴淼[1] Zhang Xingqiong;Zhang Jinglin;Yang Yuan;Yuan Yuanhong;Zhong Handi;Wu Miao(Department of Gastrointestinal Surgery,The Second People's Hospital of Yibin,Yibin,Sichuan,644000,China)

机构地区：[1]宜宾市第二人民医院胃肠外科

出　　处：《西南国防医药》2019年第12期1206-1209,共4页Medical Journal of National Defending Forces in Southwest China

基　　金：四川省宜宾市卫健委项目(2018yw001)

摘　　要：目的评估Ⅱ期结直肠癌术后患者的肿瘤病理学特征与生存预后之间的关系。方法纳入261例Ⅱ期结直肠癌患者,收集患者肿瘤病理学特征参数:肿瘤出芽、低分化簇和尾侧型同源框基因-2(CDX-2)表达,分析各参数与患者预后之间的关系。结果 161例(61.5%)、82例(31.4%)和18例(6.9%)患者的肿瘤出芽分别为1、2和3分;170例(64.9%)、72例(27.6%)和19例(7.3%)患者的肿瘤低分化簇分别为1级、2级和3级;在30例(11.5%)肿瘤样品中,检测到CDX-2为阴性。肿瘤出芽等级与肿瘤大小(P <0.05)、淋巴血管/周围神经侵犯(P <0.01)和低分化簇(P <0.01)有显著相关性。肿瘤出芽(P <0.01)和血管神经淋巴结侵犯(P <0.05)是预后的独立危险因素,肿瘤出芽的高低级别患者亚组之间的生存预后存在显著差异(P <0.05)。结论在Ⅱ期结直肠癌术后患者中,肿瘤出芽可以作为评估患者预后的有效预测因子。Objective To assess the relationship between pathological features of tumor and survival prognosis in patients receiving surgery for stage Ⅱ colorectal cancer. Methods A total of 261 patients with stage Ⅱ colorectal cancer were enrolled. The pathological parameters of the tumor were collected for the patients, including tumor budding, poorly differentiated clusters(PDCs)and caudal-related homeobox 2(CDX-2) expression. The relationship between each parameter and the patient’s prognosis was analyzed. Results The grade of tumor budding in 161(61.5%), 82(31.4%), and 18(6.9%) patients were 1, 2, and 3 respectively;170(64.9%), 72(27.6%) and 19(7.3%) patients had tumor PDC of grade 1, 2, and 3, respectively. CDX-2 was detected negative in30(11.5%) tumor samples. The grade of tumor budding was significantly associated with tumor size(P < 0.05), lymphatic vessel invasion/peripheral invasion(P < 0.01), and PDCs(P < 0.01). Tumor budding(P < 0.01) and lymphatic vessel invasion/perineural invasion(P < 0.05) were independent risk factors for prognosis. There was a significant difference in survival prognosis between subgroups of patients with high-and low-grade tumor budding(P < 0.05). Conclusion In patients receiving surgery for stage Ⅱcolorectal cancer, tumor budding can be used as an effective predictor to assess the prognosis of patients.

关 键 词：结直肠癌 肿瘤出芽 CDX-2 低分化 生存预后 

分 类 号：R735.37[医药卫生—肿瘤]