Development of a novel apoptosis-based tumor regression grade to assess the efficacy of preoperative chemoradiotherapy for rectal cancer: a retrospective single-center study
Development of a novel apoptosis-based tumor regression grade to assess the efficacy of preoperative chemoradiotherapy for rectal cancer: a retrospective single-center study
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开发一种新的基于细胞凋亡的肿瘤消退等级来评估直肠癌术前放化疗的疗效：一项回顾性单中心研究
DOI：
10.1007/s10147-021-01948-2
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发表时间：
2021
影响因子：
3.3
通讯作者：
Ishihara Soichiro
中科院分区：
文献类型：
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作者：
Ozaki Kosuke;Kawai Kazushige;Nozawa Hiroaki;Sasaki Kazuhito;Murono Koji;Ishihara Soichiro
背景术前放化疗最好用于局部进展期直肠癌，对于临床完全缓解的病例则采用观察等待策略。然而，病理学和临床完全缓解率之间存在不一致。我们的目的是提出一个肿瘤消退等级（TRG），真正反映了术前放化疗在局部进展期直肠cancer.MethodsOverall的治疗效果，293例连续T3/T4 a/T4 b直肠癌谁接受了放化疗，然后根治性手术2003年9月和2018年12月之间进行了回顾性分析。我们使用M30 cytoDEATH免疫染色评估细胞凋亡，并将其与使用苏木精-伊红染色评估的常规TRG（convTRG）相关联，并通过评估细胞凋亡和convTRG创建新的TRG。改良TRG 1 -4（modifTRG）分类如下：modifTRG 1包括差TRG，modifTRG 2中度TRG，modifTRG 3良好TRG，modifTRG 4完全凋亡和convTRG 3（病理完全响应）。我们评估了总生存率，无复发生存，和局部复发率。ResultsPathological完全缓解率为10.6%，当使用常规染色评价。用M30染色法观察到convTRG 1a、convTRG 1b、convTRG 2的残余病变中有0%、0.3%、9.2%的细胞凋亡。结合两者，在20.1%中观察到modifTRG 4。modifTRG 4和convTRG 3之间的存活率相似，表明modifTRG 4相当于病理完全缓解。然而，在多变量分析中，modifTRG，而不是convTRG是一个独立的危险因素，局部和远处recurruption.ConclusionThe建议modifTRG真实地反映了放化疗的治疗效果，可能是上级的convTRG分层直肠癌患者放化疗治疗。
BackgroundPreoperative chemoradiotherapy is used preferably for locally advanced rectal cancer, followed by a watch-and-wait strategy for cases showing clinical complete response. However, there is a discordance between pathological and clinical complete response rates. We aimed to propose a tumor regression grade (TRG) that truly reflects the therapeutic effects of preoperative chemoradiotherapy in locally advanced rectal cancer.MethodsOverall, 293 consecutive patients with T3/T4a/T4b rectal cancer who underwent chemoradiotherapy followed by radical surgery between Sep 2003 and Dec 2018 were retrospectively reviewed. We assessed apoptosis using M30 cytoDEATH immunostaining and correlated that with conventional TRG (convTRG) evaluated using hematoxylin–eosin staining, and created a new TRG by evaluating apoptosis and convTRG. The modified TRG1-4 (modifTRG) classification was as follows: modifTRG1 comprised poor TRG, modifTRG2 moderate TRG, modifTRG3 good TRG, modifTRG4 complete apoptosis and convTRG3 (pathological complete response). We assessed the overall survival, relapse-free survival, and local recurrence rate.ResultsPathological complete response rate was 10.6% when evaluated using conventional staining. Using M30 staining, apoptosis was observed in the residual disease in convTRG 1a 0%, convTRG 1b 0.3%, convTRG 2 9.2%. Combining the two, modifTRG4 was observed in 20.1%. The survival rates were similar between modifTRG4 and convTRG3, suggesting that modifTRG4 was equivalent to pathological complete response. However, in multivariate analysis, modifTRG but not convTRG was an independent risk factor for local and distant recurrences.ConclusionThe proposed modifTRG truly reflected the therapeutic effects of chemoradiotherapy and may be superior to the convTRG to stratify rectal cancer patients treated with chemoradiotherapy.
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影响因子：
45.3
作者：
O'Connell, Michael J.;Colangelo, Linda H.;Wolmark, Norman
通讯作者：
Wolmark, Norman
影响因子：
3.9
作者：
Kong, Joseph C.;Guerra, Glen R.;Heriot, Alexander G.
通讯作者：
Heriot, Alexander G.
影响因子：
50.5
作者：
Glynne-Jones, R.;Wyrwicz, L.;Arnold, D.
通讯作者：
Arnold, D.
Tateyama, H.、Tada, T.、Hattori, H.、Murase, T.、Li, W-X.、Eimoto, T.：“前缀和固定时间对片段 DNA 原位末端标记检测细胞凋亡的影响。
DOI：
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发表时间：
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期刊：
影响因子：
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作者：
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通过光学显微镜和原位末端标记检测结直肠癌中的细胞凋亡。
DOI：
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发表时间：
1997
期刊：
Analytical and quantitative cytology and histology
影响因子：
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作者：
N. Hawkins;J. Lees;R. Ward
通讯作者：
R. Ward