摘要
目的探讨结直肠腺癌中差分化肿瘤细胞群(poorly differentiated clusters,PDC)与临床病理参数之间的关系及其意义。方法收集2017年1至12月间在南京医科大学附属南京医院(南京市第一医院)行根治性手术切除的结直肠腺癌标本183例。男性122例,女性61例。年龄42~89岁,平均68岁。肿瘤大小2~14 cm,平均4.5 cm。结肠癌124例,直肠癌59例。HE染色光镜下观察结直肠腺癌PDC数量并进行分级,同时观察肿瘤周围炎性细胞反应情况,分析PDC有无及其分级与结直肠腺癌临床病理特征以及肿瘤周围炎性细胞反应之间的关系。结果183例结直肠腺癌中,104例可以见到PDC,PDC的检出率为56.8%,其中G1级36例(19.7%)、G2级28例(15.3%)、G3级40例(21.9%)。结直肠腺癌中PDC与淋巴结转移、脉管侵犯、分化程度、浸润深度和pTNM分期呈正相关(P<0.05),而与肿瘤周围炎性细胞反应无关(P>0.05),结肠癌中PDC的检出率高于直肠癌,差异有统计学意义(P<0.05),而与患者年龄、性别、肿瘤大小无关(P>0.05)。结直肠腺癌中PDC的分级与临床病理指标的关系中,伴有淋巴结转移和脉管侵犯的结直肠腺癌组织中PDC级别明显高于无淋巴结转移和无脉管浸润者(P<0.05);PDC的分级与患者年龄、分化程度和pTNM分期呈正相关(P<0.05),而与患者性别、肿瘤大小、部位和浸润深度无关(P>0.05)。PDC分级与肿瘤周围炎性反应程度之间无关(P>0.05)。结论PDC是一种预测结直肠腺癌侵袭性行为的组织学特征,与结直肠腺癌侵袭性的生物学行为密切相关。识别和评估结直肠腺癌中PDC的分级可以更好地预测结直肠腺癌的生物学行为,从而更加准确地指导结直肠癌的治疗和预后评估。
Objective To investigate the correlation between poorly differentiated clusters (PDCs) in colorectal adenocarcinomas with clinicopathological parameters and its clinicopathological significance. Methods One hundred and eighty-three colorectal adenocarcinomas resected by radical proctocolecomy were collected at Nanjing Hospital(Nanjing First Hospital), Nanjing Medical University, from January to December 2017. There were 122 male and 61 female patients with age ranging from 42 to 89 years (mean of 68 years). Tumor diameter ranged from 2 to 14 cm (mean 4.5 cm). There were 124 colon cancers and 59 rectal cancers. The number and grade of PDCs in the colorectal adenocarcinoma were evaluated by H-E staining. The overall peritumoural inflammatory reaction was also evaluated. The relationship between PDCs and tumor grades and clinicopathological features and overall peritumoural inflammatory reaction of colorectal adenocarcinoma was analyzed. Results Of 183 cases of colorectal adenocarcinoma, PDCs were seen in 104 cases (56.8%), of which 36 cases (19.7%) were grade 1, 28 cases (15.3%) were grade 2, and 40 cases (21.9%) were grade 3. PDCs were positively correlated with lymph node metastasis, vascular invasion, degree of differentiation, depth of invasion, and pTNM staging(P<0.05). The detection rate of PDCs in colon cancer was higher than that of rectal cancer(P<0.05). PDCs was unrelated to age, gender, tumor size, and degree of overall peritumoural inflammatory reaction (P>0.05). Among clinicopathological parameters, the grade of PDCs was correlated with lymph node metastasis and vascular invasion (higher than those without lymph node metastasis and vascular invasion, P<0.05);There was a positive correlation between the grade of PDCs and age, tumor differentiation and pTNM staging(P<0.05), and no significant difference between the grade of PDCs and gender, tumor size, tumor location, and depth of invasion was seen (P>0.05). There was no correlation between the grade of PDCs and the degree of overall peritumoural inflamm
作者
杨路路
苟思琪
王劲松
齐琼
黄文斌
Yang Lulu;Gou Siqi;Wang Jinsong;Qi Qiong;Huang Wenbin(Department of Pathology, Nanjing Hospital(Nanjing First Hospital), Nanjing Medical University, Nanjing 210006, China)
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2019年第4期276-281,共6页
Chinese Journal of Pathology
基金
江苏省六大人才高峰项目(2015-WSN-068).
关键词
结直肠肿瘤
细胞分化
炎症
病理学
外科
Colorectal neoplasms
Cell differentiation
Inflammation
Pathology, surgical
