The prognostic effect of perineural invasion in esophageal squamous cell carcinoma.
The prognostic effect of perineural invasion in esophageal squamous cell carcinoma.
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神经周围侵犯对食管鳞状细胞癌预后的影响
DOI：
10.1186/1471-2407-14-313
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发表时间：
2014-05-05
期刊：
影响因子：
3.8
通讯作者：
Cai MY
中科院分区：
文献类型：
--
作者：
Chen JW;Xie JD;Ling YH;Li P;Yan SM;Xi SY;Luo RZ;Yun JP;Xie D;Cai MY
神经周围浸润（PNI）与几种恶性肿瘤的不良生存率相关，但其在食管鳞状细胞癌（ESCC）中的意义仍有待明确界定。本研究的目的是确定PNI状态与临床结局之间的关系。我们回顾性评估了2000年至2007年在一个学术中心接受手术治疗的433例ESCC患者的PNI。使用斯皮尔曼等级相关、Kaplan-Meier方法、考克斯比例风险回归模型和Harrell一致性指数（C指数）分析所得数据。在433例食管鳞癌中，209例（47.7%）发现了PNI。相关分析显示，食管鳞癌PNI与肿瘤分化程度、浸润深度、pN分型及分期显著相关（P < 0.05）。PNI阴性肿瘤的5年总生存率为0.570，而PNI阳性肿瘤的5年总生存率为0.326。与PNI阳性肿瘤患者相比，PNI阴性肿瘤患者的5年无复发生存率增加了1.7倍（分别为0.531 v0.305; P < 0.0001）。在淋巴结阴性的患者中，PNI也是一个预后预测因子（P < 0.05）。在多因素分析中，PNI是影响总生存率的独立预后因素（P = 0.027）。组合模型（PNI、性别和pN状态）的C指数估计值比单独临床病理模型的C指数估计值显著改善（分别为0.739 v0.706）。PNI可以作为ESCC患者预后的独立预后因素，原发性ESCC标本中的PNI状态应被考虑用于治疗分层。
Perineural invasion (PNI) is correlated with adverse survival in several malignancies, but its significance in esophageal squamous cell carcinoma (ESCC) remains to be clearly defined. The objective of this study was to determine the association between PNI status and clinical outcomes. We retrospectively evaluated the PNI of 433 patients with ESCC treated with surgery between 2000 and 2007 at a single academic center. The resulting data were analyzed using Spearman’s rank correlation, the Kaplan-Meier method, Cox proportional hazards regression modeling and Harrell’s concordance index (C-index). PNI was identified in 209 of the 433 (47.7%) cases of ESCC. The correlation analysis demonstrated that PNI in ESCC was significantly correlated with tumor differentiation, infiltration depth, pN classification and stage (P < 0.05). The five-year overall survival rate was 0.570 for PNI-negative tumors versus 0.326 for PNI-positive tumors. Patients with PNI-negative tumors exhibited a 1.7-fold increase in five-year recurrence-free survival compared with patients with PNI-positive tumors (0.531 v 0.305, respectively; P < 0.0001). In the subset of patients with node-negative disease, PNI was evaluated as a prognostic predictor as well (P < 0.05). In the multivariate analysis, PNI was an independent prognostic factor for overall survival (P = 0.027). The C-index estimate for the combined model (PNI, gender and pN status) was a significant improvement on the C-index estimate of the clinicopathologic model alone (0.739 v 0.706, respectively). PNI can function as an independent prognostic factor of outcomes in ESCC patients, and the PNI status in primary ESCC specimens should be considered for therapy stratification.
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DOI：
10.1097/pas.0b013e31824104c5
发表时间：
2012-03
期刊：
The American journal of surgical pathology
影响因子：
--
作者：
Chatterjee D;Katz MH;Rashid A;Wang H;Iuga AC;Varadhachary GR;Wolff RA;Lee JE;Pisters PW;Crane CH;Gomez HF;Abbruzzese JL;Fleming JB;Wang H
通讯作者：
Wang H
影响因子：
9
作者：
FUJITA, H;KAKEGAWA, T;MIZUTANI, K
通讯作者：
MIZUTANI, K
影响因子：
45.3
作者：
Allum, William H.;Stenning, Sally P.;Langley, Ruth E.
通讯作者：
Langley, Ruth E.
影响因子：
29.4
作者：
BOCKMAN, DE;BUCHLER, M;BEGER, HG
通讯作者：
BEGER, HG
影响因子：
6.2
作者：
Peng, Junjie;Sheng, Weiqi;Cai, Sanjun
通讯作者：
Cai, Sanjun