The prognostic value of histological tumor necrosis in solid organ malignant disease: a systematic review
The prognostic value of histological tumor necrosis in solid organ malignant disease: a systematic review
复制标题
DOI：
10.2217/fon.11.99
复制
发表时间：
2011-10-01
期刊：
影响因子：
3.3
通讯作者：
McMillan, Donald C.
中科院分区：
文献类型：
--
作者：
Richards, Colin H.;Mohammed, Zahra;McMillan, Donald C.
背景：肿瘤坏死被认为是多种实体器官恶性肿瘤预后不良的标志。尽管如此，其评估尚未被纳入常规临床实践，与癌症结局关系的机制尚未确定。目的：研究肿瘤坏死在实体器官恶性疾病中的预后价值，并总结已知的临床、病理和炎症相关性。方法：由两名评价者根据预定义的方案对1966-2011年发表的数据进行系统评价。最终审查共纳入了57项与肾脏（n = 23）、乳腺（n = 13）、肺（n = 7）、结直肠（n = 5）和其他实体瘤（n = 9）相关的独立研究。结论：现在有大量的证据证实肿瘤坏死在实体器官恶性疾病中的预后价值。坏死和其他高危肿瘤特征之间存在一致的相关性，但生存影响似乎与病理分期无关。我们认为，与宿主炎症反应的关系，无论是局部还是全身，可以解释肿瘤坏死对癌症预后的影响。
Background: Tumor necrosis has been proposed as a marker of poor prognosis in a variety of solid organ malignant tumor types. Despite this, its assessment has yet to be adopted into routine clinical practice and the mechanisms underpinning the relationships with cancer outcome are undetermined. Aims: To examine the prognostic value of tumor necrosis in solid organ malignant disease and to summarize the known clinical, pathological and inflammatory associations. Methods: A systematic review of data published from 1966-2011 was undertaken by two reviewers according to a predefined protocol. A total of 57 independent studies relating to renal (n = 23), breast (n = 13), lung (n = 7), colorectal (n = 5) and other solid tumors (n = 9) were included in the final review. Conclusion: There is now a substantial body of evidence confirming the prognostic value of tumor necrosis in solid organ malignant disease. There are consistent associations between necrosis and the presence of other high-risk tumor characteristics but the survival impact appears to be independent of pathological stage. We propose that relationships with the host inflammatory response, both local and systemic, may explain the influence of tumor necrosis on cancer outcome.