Pathological classification of desmoplastic reaction is prognostic factor in cervical adenocarcinoma
Pathological classification of desmoplastic reaction is prognostic factor in cervical adenocarcinoma
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DOI：
10.1007/s00795-022-00329-6
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发表时间：
2022-07-25
影响因子：
1.8
通讯作者：
Saito, Tsuyoshi
中科院分区：
文献类型：
--
作者：
Akimoto, Taishi;Takasawa, Akira;Saito, Tsuyoshi
促结缔组织增生反应（DR）和炎症是多种肿瘤发生的重要病理表现。然而，这些间质反应和宫颈腺癌之间的相关性记录不多。本研究阐明了DR是否是早期宫颈腺癌患者的预后指标。59例早期宫颈腺癌（I/II期）患者纳入本研究。DR分为三组，成熟，中间，和未成熟的基础上存在的粘液样间质和透明化瘢痕疙瘩样胶原。炎症细胞反应分为轻度、中度和重度。这些间质反应分别在浸润前间质和瘤内间质中进行评价。在肿瘤内和浸润前间质中，中间/未成熟DR与肿瘤大小、T分期、N分期、淋巴管浸润和宫旁浸润相关（p < 0.001至p < 0.05）。此外，在瘤内基质中，中间/未成熟DR导致短的无复发生存期和总生存期（p < 0.001）。在浸润前沿间质中，炎性细胞反应与DR不成熟和FIGO分期相关（p < 0.01）。这些结果表明，DR成熟度分类是早期宫颈腺癌患者的潜在预后生物标志物。DR可通过常规H&E染色而无需免疫组化进行评估，在临床实践中方便且经济。
Desmoplastic reaction (DR) and inflammation are significant pathological manifestations of tumorigenesis in several cancers. However, the correlation between these stromal reactions and cervical adenocarcinoma has been poorly documented. This investigation elucidated whether DR is a prognostic indicator in early cervical adenocarcinoma patients. Fifty-nine patients with early stage cervical adenocarcinoma (stages I/II) were included in the study. DR was divided into three groups, mature, intermediate, and immature, based on the presence of myxoid stroma and hyalinized keloid-like collagen. Inflammatory cell responses were classified as mild, moderate, and severe. Those stromal reactions were separately evaluated in the invasion front stroma and intratumoral stroma. In both the intratumor and invasion front stroma, intermediate/immature DR was correlated with tumor size, T stage, N stage, lymphovascular invasion, and parametrial infiltration (p < 0.001 to p < 0.05). In addition, in the intratumoral stroma, intermediate/immature DR led to short relapse-free survival and overall survival (p < 0.001). In the invasion front stroma, inflammatory cell responses were associated with DR immaturity and FIGO stage (p < 0.01). These results suggest that the classification of DR maturity is a potential prognostic biomarker in early stage cervical adenocarcinoma patients. DR can be evaluated by routine H&E staining without immunohistochemistry, making it convenient and economical in clinical practice.