High tumor budding predicts a poor prognosis in resected duodenal adenocarcinoma
High tumor budding predicts a poor prognosis in resected duodenal adenocarcinoma
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DOI：
10.1007/s00595-021-02433-z
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发表时间：
2022-01-06
期刊：
影响因子：
2.5
通讯作者：
Sekimoto, Mitsugu
中科院分区：
文献类型：
--
作者：
Sakaguchi, Tatsuma;Satoi, Sohei;Sekimoto, Mitsugu
目的肿瘤出芽是指在肿瘤浸润前沿出现小簇癌细胞的一种组织学特征。其在十二指肠腺癌（DA）中的意义尚未完全描述。方法采用单中心回顾性研究。纳入了2006年1月至2018年12月在关西医科大学医院接受组织学诊断为DA的根治性手术的患者。每0.785 mm（2）计数肿瘤出芽，并将其分类为低（0-4个芽）、中等（5-9个芽）或高（>= 10个芽）。结果共纳入47例患者。5年总生存率和无复发生存率分别为77%和72%。15例患者（32%）出现高度肿瘤出芽。在多变量分析中，排除浅表型（pT 1）DA患者（n = 22），高肿瘤萌芽[风险比（HR）13.4，p = 0.028]、区域淋巴结转移（HR 19.9，p = 0.039）和辅助化疗（HR 0.056，p = 0.036）是与总生存期相关的独立因素。远处转移的发生率显着更经常在患者谁有高肿瘤萌芽比其他人（p = 0.039）。结论高肿瘤出芽率是切除后DA预后不良的预测因素。
Purpose Tumor budding is a histological characteristic defined as the presence of small clusters of cancer cells at the invasion front. Its significance in duodenal adenocarcinoma (DA) has not been fully described. Methods A single-center, retrospective study was conducted. Patients who underwent curative surgery for histologically diagnosed DA from January 2006 to December 2018 at Kansai Medical University Hospital were included. Tumor budding was counted per 0.785 mm(2) and classified as low (0-4 buds), intermediate (5-9 buds), or high (>= 10 buds). Results In total, 47 patients were included. The 5-year overall survival and relapse-free survival rates were 77% and 72%, respectively. High tumor budding was seen in 15 patients (32%). Excluding patients with superficial type (pT1) DA (n = 22), high tumor budding [hazard ratio (HR) 13.4, p = 0.028], regional lymph node metastasis (HR 19.9, p = 0.039), and adjuvant chemotherapy (HR 0.056, p = 0.036) were independent factors related to the overall survival in multivariate analyses. Distant metastases occurred significantly more often in patients who had high tumor budding than in others (p = 0.039). Conclusion The data suggest that high tumor budding is a predictor of a poor prognosis in resected DA.