Clinical Impact of Mesorectal Extranodal Cancer Tissue in Rectal Cancer: Detailed Pathological Assessment Using Whole-Mount Sections
Clinical Impact of Mesorectal Extranodal Cancer Tissue in Rectal Cancer: Detailed Pathological Assessment Using Whole-Mount Sections
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DOI：
10.1007/dcr.0b013e3181cf7fd8
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发表时间：
2010-05-01
影响因子：
3.9
通讯作者：
Takii, Yasumasa
中科院分区：
文献类型：
--
作者：
Shimada, Yoshifumi;Takii, Yasumasa
目得：没有显示淋巴结结构的组织学证据（结癌组织）的直肠系膜癌沉积物是直肠癌的常见特征。然而，使用TNM分级的结直肠癌组织的最佳分类尚未建立。我们回顾了结直肠癌组织的详细使用整体安装节段，以澄清其临床impairment.METHODS：这项回顾性研究涉及214例连续的I-III期直肠癌患者。固定后，将包括直肠系膜在内的整个肿瘤块切成纵向切片并染色。直肠系膜受累分为直接肿瘤浸润、淋巴结受累或结癌组织。对结外癌组织进行形态学分类，并测量其最大大小和距原发肿瘤的距离。结果：88例（41.1%）共检出498个结直肠癌沉积物。多变量考克斯比例风险模型分析表明，结直肠癌组织的存在是无复发（P < .001）和总生存（P < .003）的独立预后因素。无论形态学分类如何，结直肠癌组织的风险比均高于淋巴结受累。的临床影响显着不同的组织学类型的结节癌组织的数量，存款的数量，其最大尺寸，并从原发tumor.CONCLUSIONS的距离：在本研究中，我们已经表明，结节癌组织检测到的整体安装部分有一个临床影响，是更严重的比淋巴结的参与。
PURPOSE: Mesorectal cancer deposits showing no histological evidence of lymph node structure (extranodal cancer tissue) are a common feature in rectal cancer. However, optimal categorization of extranodal cancer tissue using TNM grading is not yet established. We reviewed extranodal cancer tissue in detail using whole-mount sections to clarify its clinical impact.METHODS: This retrospective study involved 214 consecutive patients with stage I-III rectal cancer. After fixation, the whole tumor mass including the mesorectum was sliced into longitudinal sections and stained. Mesorectal involvement was classified as direct tumor infiltration, lymph node involvement, or extranodal cancer tissue. Extranodal cancer tissue was classified morphologically, and its maximum size and distance from the primary tumor were measured. The clinical impact of extranodal cancer tissue was evaluated by univariate and multivariate analyses.RESULTS: A total of 498 extranodal cancer deposits were detected in 88 patients (41.1%). Multivariate Cox proportional hazards model analysis indicated that the presence of extranodal cancer tissue was an independent prognostic factor for relapse-free (P < .001) and overall survival (P < .003). The hazard ratio for extranodal cancer tissue was higher than for nodal involvement, irrespective of morphological classification. The clinical impact differed significantly with the number of histological types of extranodal cancer tissue, the number of deposits, their maximum size, and their distance from the primary tumor.CONCLUSIONS: In the present study, we have shown that extranodal cancer tissue detected by whole-mount sections has a clinical impact that is more severe than nodal involvement.