Prognostic significance and molecular associations of tumor growth pattern in colorectal cancer.
Prognostic significance and molecular associations of tumor growth pattern in colorectal cancer.
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DOI：
10.1245/s10434-011-2174-5
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发表时间：
2012-06
影响因子：
3.7
通讯作者：
Ogino S
中科院分区：
文献类型：
--
作者：
Morikawa T;Kuchiba A;Qian ZR;Mino-Kenudson M;Hornick JL;Yamauchi M;Imamura Y;Liao X;Nishihara R;Meyerhardt JA;Fuchs CS;Ogino S
肿瘤边缘的浸润性生长模式与较短的患者生存期有关。然而，对肿瘤生长模式的预后意义知之甚少，不依赖于肿瘤分子改变和其他组织学特征。利用两项前瞻性队列研究中1139例结直肠癌患者的数据库，由一名病理学家记录肿瘤生长方式、肿瘤分化、淋巴细胞反应、粘液成分、印环细胞成分等组织学特征。使用Cox比例风险模型计算死亡率风险比（HR），调整临床、病理和肿瘤分子特征，包括微卫星不稳定性（MSI）、CpG岛甲基化表型、LINE-1甲基化以及KRAS、BRAF和PIK3CA突变。在1139例结直肠癌中，我们观察到372例（33%）肿瘤呈扩张性生长，610例（54%）肿瘤呈中等生长，157例（14%）肿瘤呈浸润性生长。与扩张性生长模式患者相比，浸润性生长模式患者的肿瘤特异性生存期较短[log-rank p<0.0001；多元HR = 1.74;95%置信区间（CI）， 1.22-2.47]和总生存率[log-rank p<0.0001；多元HR = 1.78;95% ci, 1.33-2.39]。浸润性生长模式与预后的相关性仅限于I-III期患者（p -相互作用与分期=0.0001）。浸润性生长模式与I-III期结直肠癌患者预后较差相关，与其他临床、病理和分子特征无关。
Infiltrative growth pattern at the tumor margin has been associated with shorter patient survival. However, little is known on prognostic significance of tumor growth pattern, independent of tumoral molecular alterations and other histological features. Utilizing a database of 1139 colon and rectal cancer patients in two prospective cohort studies, histological features including tumor growth pattern, tumor differentiation, lymphocytic reaction, mucinous component, and signet ring cell component were recorded by a single pathologist. Cox proportional hazards model was used to compute mortality hazard ratio (HR), adjusting for clinical, pathological and tumor molecular features, including microsatellite instability (MSI), the CpG island methylator phenotype, LINE-1 methylation, and KRAS, BRAF, and PIK3CA mutations. Among 1139 colorectal cancers, we observed expansile growth pattern in 372 tumors (33%), intermediate growth pattern in 610 tumors (54%), and infiltrative growth pattern in 157 tumors (14%). Compared to patients with expansile growth pattern, those with infiltrative growth pattern experienced shorter cancer-specific survival [log-rank p<0.0001; multivariate HR=1.74; 95% confidence interval (CI), 1.22-2.47] and overall survival [log-rank p<0.0001; multivariate HR=1.78; 95% CI, 1.33-2.39]. The prognostic association of infiltrative growth pattern was confined to stage I-III patients (Pinteraction with stage=0.0001). Infiltrative growth pattern was associated with worse prognosis among stage I-III colorectal cancer patients, independent of other clinical, pathologic, and molecular characteristics.
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影响因子：
50.5
作者：
Farina-Sarasqueta, A.;van Lijnschoten, G.;van den Brule, A. J. C.
通讯作者：
van den Brule, A. J. C.
影响因子：
3.7
作者：
Nosho K;Irahara N;Shima K;Kure S;Kirkner GJ;Schernhammer ES;Hazra A;Hunter DJ;Quackenbush J;Spiegelman D;Giovannucci EL;Fuchs CS;Ogino S
通讯作者：
Ogino S
影响因子：
5.6
作者：
Greenson, JK;Bonner, JD;Gruber, SB
通讯作者：
Gruber, SB
影响因子：
3.7
作者：
Muratore, Andrea;Ribero, Dario;Capussotti, Lorenzo
通讯作者：
Capussotti, Lorenzo
影响因子：
--
作者：
Colomer, A;Erill, N;Puig, X
通讯作者：
Puig, X