Prognostic and predictive factors of oesophageal carcinoma
Prognostic and predictive factors of oesophageal carcinoma
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DOI：
10.1684/bdc.2008.0778
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发表时间：
2009-04-01
影响因子：
1.2
通讯作者：
Hennequin, C.
中科院分区：
文献类型：
--
作者：
Blanchard, P.;Quero, L.;Hennequin, C.
食管癌是一种常见病，发病率高且稳定（法国每年新发病例6,000例）。其流行病学在过去三十年中发生了变化，腺癌成为最常见的组织学亚型。这是一种具有早期淋巴扩散的侵袭性疾病。尽管诊断和治疗策略有所改进，但食管癌的预后仍然较差。本综述的目的是描述食管癌的主要预后和预测因素。这些因素主要基于患者特征（体能状态、体重减轻、血红蛋白水平）、肿瘤扩散（TNM分期、淋巴结微转移、受累淋巴结比例、囊外受累）、手术切除的根治性（R0）或放化疗治疗的放射学和内镜反应。许多分子预后因素也已被描述，其中值得一提的是 p53 突变的存在或高水平的 NF-κ B。通过 PET-CT 测量的肿瘤葡萄糖摄取的早期下降似乎是抗肿瘤治疗反应的预测因素。食管癌药物作用途径的遗传谱已被描述。它们可以提供额外的信息来预测肿瘤对药物治疗的反应。
Oesophageal carcinoma is a frequent disease, which incidence is high and stable (6,000 new cases per year in France). Its epidemiology has changed over the last three decades, adenocarcinoma becoming the most frequent histologic subtype. It is an aggressive disease with an early lymphatic spread. The prognosis of oesophageal carcinoma remains poor despite improved diagnosis and therapeutic strategies. The aim of this review is to describe the major prognostic and predictive factors of oesophageal carcinoma. These factors are mostly based on patient characteristics (performance status, weight loss, hemoglobin level), tumor spread (TNM stage, lymph node micrometastases, ratio of involved lymph nodes, extracapsular involvement), radicality of surgical resection (R0) or radiological and endoscopic response to chemoradiation therapy. Many molecular prognostic factors have also been described, among which the presence p53 mutations or high-levels of NF-kappa B are worth naming. An early decrease of tumoral glucose uptake measured by PET-CT appears to be a predictive factor of response to antitumor treatment. Genetic profiles of drug action pathways in oesophageal carcinoma have been described. They may provide additional information to predict tumor response to medical treatment.