Prognostic significance of histological features and biological parameters in stage I (pT1 and pT2) colorectal adenocarcinoma
Prognostic significance of histological features and biological parameters in stage I (pT1 and pT2) colorectal adenocarcinoma
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DOI：
10.1016/j.prp.2006.05.003
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发表时间：
2006-01-01
影响因子：
2.8
通讯作者：
de Leon, Maurizio Ponz
中科院分区：
文献类型：
--
作者：
Losi, Lorena;Ponti, Giovanni;de Leon, Maurizio Ponz
I期结直肠癌患者预后良好，但有一小部分患者在根治性切除术后死于局部或远处复发。这种侵袭行为反映了这些肿瘤的某些生物学特性。在这项研究中，我们评估了一些组织病理学和生物学参数在I期结直肠癌的预后作用。从Modena的结直肠癌登记处，我们选择了两个系列的患者;第一个包括所有死于疾病进展的患者，第二个包括预后良好的患者。评估的组织病理学参数包括分化程度、浸润性肿瘤前沿的生长模式、瘤周淋巴细胞浸润、肿瘤出芽和血管浸润。结果表明，浸润性生长方式、瘤周淋巴细胞浸润、肿瘤出芽和血管浸润与复发风险显著相关。在生物学参数中，p53过表达与不良临床结局显著相关。我们的研究表明，组织病理学特征是相关的预后指标，并可作为标记物，为适当的治疗策略，在患者的第一阶段癌症。(c)2006年Elsevier GmbH。All rights reserved.
Patients with stage I colorectal cancer have a good prognosis, however, a small fraction of them die of local or distant recurrence after curative resection. The aggressive behavior reflects some biological properties of these tumors. In this study, we evaluated the prognostic role of some histopathological and biological parameters in stage I colorectal carcinomas. From the Colorectal Cancer Registry of Modena, we selected two series of patients; the first included all patients who had died of disease progression, the second included patients with a favorable outcome. The histopathological parameters assessed were grade of differentiation, growth pattern at the invasive tumor front, peritumoral lymphocytic infiltration, tumor budding and vascular invasion. The biological variables were proliferative activity (using Ki-67 nuclear antigen), overexpression of p53 protein and altered expression of the mismatch repair proteins (MLH1 and MSH2).The results showed that an infiltrating growth pattern, absent or sparse peritumoral lymphocytic infiltration, the presence of tumor budding and vascular invasion are significantly related to the risk of recurrence. Among the biological parameters, p53 overexpression was significantly correlated with a poor clinical outcome. Our study showed that the histopathologial features are relevant prognostic indicators and might be used as markers for an appropriate treatment strategy in patients with stage I carcinomas. (c) 2006 Elsevier GmbH. All rights reserved.