Morphological consistency of desmoplastic reactions between the primary colorectal cancer lesion and associated metastatic lesions
Morphological consistency of desmoplastic reactions between the primary colorectal cancer lesion and associated metastatic lesions
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DOI：
10.1007/s00428-019-02742-2
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发表时间：
2020-07-01
期刊：
影响因子：
3.5
通讯作者：
Ueno, Hideki
中科院分区：
文献类型：
--
作者：
Ao, Tadakazu;Kajiwara, Yoshiki;Ueno, Hideki
先前的一些研究表明，原发肿瘤（DRprimary）侵袭性前沿的促纤维增生反应（DR）是一个有希望的预后指标，其组织学分类是结直肠癌（CRC）患者的独立预后因素。尽管在转移性病灶中观察到 DR，例如淋巴结 (DRLN) 和肝脏 (DRliver)，但 DR（原发性）和转移性病灶 DR 之间的关联尚不清楚。我们研究了 DR(LN) 和 DR(肝脏) 是否可以按照与 DR(原发性) 相同的方式进行分类，并检查 DR(LN) 和 DRliver 的特征和预后意义。在这项研究中，我们评估了 363 名淋巴结转移患者和 45 名同时接受根治性切除的肝转移患者。根据转移灶中瘢痕疙瘩样胶原和粘液样基质的外观，将 DR（LN）和 DR（肝脏）状态分为成熟、中间或未成熟。总体而言，成熟、中间和不成熟 DRLN 的患者分别为 109、106 和 148 名；总共有 5 名、21 名和 19 名患者具有成熟、中间和不成熟 DR 肝脏。 DR（LN）和DRprimary（spearman's rho = 0.43，P < 0.0001）以及DR（肝脏）和DRprimary（spearman's rho = 0.40，P = 0.0069）均显着相关。成熟/中期 DR(LN) 术后 5 年无复发生存率 (RFS) 为 67.7%，未成熟 DRLN 为 52.9%；成熟/中期 DR（肝脏）肝切除后 5 年 RFS 为 11.5%，未成熟 DR 肝脏为 5.6%。总之，DR(LN)和DR(肝脏)可以按照与DRprimary相同的方式分类；在原发性病变和转移性病变之间观察到 DR 的形态学一致性。
Some preceding studies show that a desmoplastic reaction (DR) at the invasive front of a primary tumor (DRprimary) is a promising prognostic indicator, and its histologic classification is an independent prognostic factor in patients with colorectal cancer (CRC). Although DR is observed in metastatic lesions, such as those in lymph nodes (DRLN) and the liver (DRliver), the association between DR(primary)and DR of metastatic lesions is unclear. We investigated whether DR(LN)and DR(liver)could be categorized in the same manner as DR(primary)and examined the features and prognostic implications of DR(LN)and DRliver. In this study, we evaluated 363 patients with metastases to lymph nodes and 45 patients with synchronous liver metastases who underwent curative resection. DR(LN)and DR(liver)statuses were classified as mature, intermediate, or immature, based on keloid-like collagen and myxoid stroma appearances in the metastatic lesions. Overall, 109, 106, and 148 patients had mature, intermediate, and immature DRLN, respectively; in total, 5, 21, and 19 patients had mature, intermediate, and immature DRliver, respectively. DR(LN)and DRprimary(spearman's rho = 0.43,P < 0.0001) and DR(liver)and DRprimary(spearman's rho = 0.40,P = 0.0069) were each significantly correlated. The 5-year relapse-free survival (RFS) after surgery was 67.7% for mature/intermediate DR(LN)and 52.9% for immature DRLN; the 5-year RFS after hepatectomy was 11.5% for mature/intermediate DR(liver)and 5.6% for immature DRliver. In conclusion, DR(LN)and DR(liver)may be classified in the same manner as DRprimary; morphological consistency of DR was observed between primary and metastatic lesions.