Histological growth patterns of colorectal cancer liver metastases: a strong prognostic marker associated with invasive patterns of the primary tumor and p53 alteration
Histological growth patterns of colorectal cancer liver metastases: a strong prognostic marker associated with invasive patterns of the primary tumor and p53 alteration
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DOI：
10.1016/j.humpath.2022.02.015
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发表时间：
2022-03-29
期刊：
影响因子：
3.3
通讯作者：
Ushiku, Tetsuo
中科院分区：
文献类型：
--
作者：
Abe, Hiroyuki;Yasunaga, Yoichi;Ushiku, Tetsuo
肿瘤-肝实质界面的肝转移的组织学生长模式(促结缔组织生长模式、推进型和替换型)是结直肠癌患者的预后因素。然而，关于其与原发肿瘤特征和分子改变的相关性的数据有限。本研究评价了136例未经手术治疗的结直肠癌肝转移瘤的组织学生长规律，并与原发灶的临床病理特征进行了比较。74例(54%)肝转移以非促结缔组织增生型为主，与肝静脉侵犯(P=0.025)、无复发生存率(P<；0.001)和总生存率(P=0.008)有关。在多因素分析中，多发肿瘤(P<；0.001)和非促结缔组织增生型(P=0.009)与较差的无复发生存率相关，肿瘤大小(P=0.025)和非促结缔组织增生型(P=0.025)与总生存率较差相关。在88例有原发癌组织切片的患者中，肝转移灶中的非结缔组织增生型与高级别肿瘤萌芽(P=0.002)、高级别低分化簇(P=0.021)、无粘液组织学(P=0.016)和P53异常表达(完全缺失或过度表达；P=0.001)相关。综上所述，肝转移灶的组织学生长模式是影响结直肠癌预后的重要因素。我们的观察强调了肝转移瘤的组织生长模式与原发肿瘤的组织病理学特征之间的重要联系，特别是侵袭性前沿形态和p53异常。(C)2022由Elsevier Inc.发表。
The histological growth pattern of liver metastases (desmoplastic, pushing, and replacement patterns) at the tumor -liver parenchymal interface is a prognostic factor in patients with colorectal cancer. However, data regarding its association with the primary tumor characteristics and molecular alterations are limited. This study evaluated the histological growth pattern in 136 cases of colorectal cancer liver metastases without preoperative treatment, comparing it with the clinicopathological features of the primary tumor. Liver metastasis exhibiting predominantly non-desmoplastic pattern (< 50%), observed in 74 cases (54%), was associated with hepatic vein invasion (P = 0.025), worse recurrence-free survival (P < 0.001) and overall survival (P = 0.008). In multivariate analyses, multiple tumors (P < 0.001) and non-desmoplastic patterns (P = 0.009) were associated with worse recurrence-free survival, and tumor size (P = 0.025) and non-desmoplastic pattern (P = 0.025) were associated with worse overall survival. In 88 patients with available primary tumor tissue slides, nondesmoplastic pattern in the liver metastasis was associated with high-grade tumor budding (P = 0.002), high-grade poorly differentiated cluster (P = 0.021), absence of mucinous histology (P = 0.016), and aberrant p53 expression (complete loss or overexpression; P 0.001) of the primary colorectal cancer. In conclusion, the histological growth pattern in liver metastasis was a strong and independent prognostic factor for colorectal cancer. Our observations highlight the significant associations between histological growth patterns in liver metastases and histopathological features of the primary tumor, especially invasive front morphology and p53 aberration.(c) 2022 Published by Elsevier Inc.