Detail histologic analysis of nerve plexus invasion in invasive ductal carcinoma of the pancreas and its prognostic impact
Detail histologic analysis of nerve plexus invasion in invasive ductal carcinoma of the pancreas and its prognostic impact
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DOI：
10.1097/pas.0b013e318065bfe6
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发表时间：
2007-11-01
影响因子：
5.6
通讯作者：
Ochiai, Atsushi
中科院分区：
文献类型：
--
作者：
Mitsunaga, Shuichi;Hasebe, Takahiro;Ochiai, Atsushi
神经丛侵犯被视为胰腺浸润性导管癌（IDC）最重要的预后因素之一，尽管尚未根据详细的组织学研究评估神经丛侵犯对预后的影响。本研究的目的是精确检查神经丛侵犯的形态学特征，并与胰腺IDC众所周知的预后参数相比，分析其预后预测能力。对75例胰头胰腺IDC患者的结局和组织学特征进行了研究，并对422处神经丛侵犯病灶进行了评估。侵犯神经丛的肿瘤细胞呈现导管形成的分化特征，且主要存在于神经束膜和神经周间隙。多变量分析显示，除了浸润性肿瘤大小和肿瘤坏死外，神经丛侵犯中从神经丛侵犯到胰腺包膜的距离以及神经丛侵犯中的神经周侵犯也是重要的预后因素。
Nerve plexus invasion is regarded as one of the most important prognostic factors in invasive ductal carcinoma (IDC) of the pancreas, though nerve plexus invasion has not been evaluated in terms of prognostic impact on the basis of detailed histologic investigation. The purpose of this study was to precisely examine morphologic characteristics of nerve plexus invasion and analyze its prognostic predictive power compared with the well-known prognostic parameters of pancreatic IDCs. The outcome and histologic features of 75 patients with pancreatic IDC in the pancreas head were investigated, and 422 lesions of nerve plexus invasion were evaluated. Tumor cells invading nerve plexus showed a duct-forming differentiated feature and predominantly existed in the perineurium and perineural space. Multivariate analyses revealed that the important prognostic factors, in addition to invasive tumor size and tumor necrosis, were at long distances from nerve plexus invasion to pancreatic capsule and perineural invasion in nerve plexus invasion.