Tumour invasiveness, the local and systemic environment and the basis of staging systems in colorectal cancer.
Tumour invasiveness, the local and systemic environment and the basis of staging systems in colorectal cancer.
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DOI：
10.1038/bjc.2017.108
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发表时间：
2017-05-23
影响因子：
8.8
通讯作者：
McMillan DC
中科院分区：
文献类型：
--
作者：
Park JH;van Wyk H;Roxburgh CSD;Horgan PG;Edwards J;McMillan DC
本研究旨在探讨原发性可手术结直肠癌患者肿瘤侵袭性（T期）、局部和全身环境与癌症特异性生存（CSS）之间的关系。采用炎症浸润（Klintrup-Makinen （KM）分级和免疫评分）、肿瘤基质百分比（TSP）和肿瘤出芽测量肿瘤微环境。采用改良格拉斯哥预后评分（mGPS）和中性粒细胞：淋巴细胞比率（NLR）检查全身炎症环境。检查5年CSS。共纳入331例患者。T期升高与结肠原发期、N期、分化不良、边缘受累及静脉侵犯相关（P<0.05）。T分期与KM分级（P=0.001）、免疫评分（P=0.016）、TSP （P=0.006）、肿瘤出芽（P<0.001）、mGPS和NLR升高（P< 0.05）相关。在T3癌患者中，N期分层生存率为88 - 64%，而免疫评分和出芽分层生存率分别为100 - 70%和91 - 56%。格拉斯哥微环境评分（Glasgow Microenvironment Score）是一种基于KM分级和TSP的评分，将生存率从93%划分为58%。虽然与T期增加有关，但局部和全身肿瘤环境特征，特别是免疫评分、出芽、TSP和mGPS是独立于分期的生存决定因素，可用于原发性可手术结直肠癌患者的分期。
The present study aimed to examine the relationship between tumour invasiveness (T stage), the local and systemic environment and cancer-specific survival (CSS) of patients with primary operable colorectal cancer. The tumour microenvironment was examined using measures of the inflammatory infiltrate (Klintrup-Makinen (KM) grade and Immunoscore), tumour stroma percentage (TSP) and tumour budding. The systemic inflammatory environment was examined using modified Glasgow Prognostic Score (mGPS) and neutrophil:lymphocyte ratio (NLR). A 5-year CSS was examined. A total of 331 patients were included. Increasing T stage was associated with colonic primary, N stage, poor differentiation, margin involvement and venous invasion (P<0.05). T stage was significantly associated with KM grade (P=0.001), Immunoscore (P=0.016), TSP (P=0.006), tumour budding (P<0.001), and elevated mGPS and NLR (both P<0.05). In patients with T3 cancer, N stage stratified survival from 88 to 64%, whereas Immunoscore and budding stratified survival from 100 to 70% and from 91 to 56%, respectively. The Glasgow Microenvironment Score, a score based on KM grade and TSP, stratified survival from 93 to 58%. Although associated with increasing T stage, local and systemic tumour environment characteristics, and in particular Immunoscore, budding, TSP and mGPS, are stage-independent determinants of survival and may be utilised in the staging of patients with primary operable colorectal cancer.
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DOI：
10.1002/path.1700350303
发表时间：
1932-01-01
期刊：
JOURNAL OF PATHOLOGY AND BACTERIOLOGY
影响因子：
--
作者：
Dukes, CE
通讯作者：
Dukes, CE
影响因子：
1.6
作者：
Li J;Yi CH;Hu YT;Li JS;Yuan Y;Zhang SZ;Zheng S;Ding KF
通讯作者：
Ding KF
影响因子：
7.8
作者：
Koelzer, Viktor H.;Dawson, Heather;Zlobec, Inti
通讯作者：
Zlobec, Inti
影响因子：
10.3
作者：
O'Connell, JB;Maggard, MA;Ko, CY
通讯作者：
Ko, CY
影响因子：
7.3
作者：
Galon, Jerome;Mlecnik, Bernhard;Bindea, Gabriela;Angell, Helen K.;Berger, Anne;Lagorce, Christine;Lugli, Alessandro;Zlobec, Inti;Hartmann, Arndt;Bifulco, Carlo;Nagtegaal, Iris D.;Palmqvist, Richard;Masucci, Giuseppe V.;Botti, Gerardo;Tatangelo, Fabiana;Delrio, Paolo;Maio, Michele;Laghi, Luigi;Grizzi, Fabio;Asslaber, Martin;D'Arrigo, Corrado;Vidal-Vanaclocha, Fernando;Zavadova, Eva;Chouchane, Lotfi;Ohashi, Pamela S.;Hafezi-Bakhtiari, Sara;Wouters, Bradly G.;Roehrl, Michael;Nguyen, Linh;Kawakami, Yutaka;Hazama, Shoichi;Okuno, Kiyotaka;Ogino, Shuji;Gibbs, Peter;Waring, Paul;Sato, Noriyuki;Torigoe, Toshihiko;Itoh, Kyogo;Patel, Prabhu S.;Shukla, Shilin N.;Wang, Yili;Kopetz, Scott;Sinicrope, Frank A.;Scripcariu, Viorel;Ascierto, Paolo A.;Marincola, Francesco M.;Fox, Bernard A.;Pages, Franck
通讯作者：
Pages, Franck