早期T3期结直肠癌环形和纵向切缘阳性的预测因素。

IF 1.6 Q4 ONCOLOGY International Journal of Surgical Oncology Pub Date : 2020-06-27 eCollection Date: 2020-01-01 DOI:10.1155/2020/6789709
M Ashraf Balbaa, Noha Elkady, Emad M Abdelrahman
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引用次数: 10

摘要

背景:结直肠癌(CRC)手术切除后恶性累及圆周切除缘(CRM)和纵向切除缘(LRM)与较高的复发率和远处转移的发生有关。这可能会影响患者的整体预后。当前研究的目的是确定病理因素作为早期T3 CRC切除边缘受累的预测因素。患者和方法。50例放射学诊断为cT3a/b (CRC)的患者被纳入研究。切除后,进行病理检查以确定CRM和/或LRM阳性患者。评估不同病理参数与CMR和LRM受累的关系。结果:CRM阳性17例(34%),LRM阳性6例(12%)。双侧切缘受累与直肠肿瘤、总体外观浸润性、III级、深部浸润和淋巴结转移阳性的肿瘤显著相关。此外,切缘的阳性与其他病理参数如印戒癌、肿瘤出芽、神经和血管浸润、高微血管密度(MVD)和正弦血管模式之间存在显著关联,而坏死和浸润性肿瘤前沿的存在仅与CRM累及显著相关。肿瘤浸润深度和印戒癌分别被确定为CRM和LRM阳性的独立预测因素。结论:术前对这些病理参数的识别可指导制定相应的治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Predictive Factors of Positive Circumferential and Longitudinal Margins in Early T3 Colorectal Cancer Resection.

Background: Malignant involvement of circumferential resection margin (CRM) and longitudinal resection margin (LRM) after surgical resection of colorectal cancer (CRC) are associated with higher rates of recurrence and development of distant metastasis. This can influence the overall patient's prognosis. The aim of the current study was to identify pathological factors as predictors for the involvement of resection margins in early T3 CRC. Patients and Methods. Fifty patients radiologically diagnosed to have cT3a/b (CRC) were included in the study. After resection, the pathological examination was performed to identify patients with positive CRM and/or LRM. Relations between the different pathological parameters and the CMR and LRM involvements were assessed.

Results: Positive CRM was present in 17 cases (34%), while positive LRM was found in 6 cases (12%). The involvement of both margins was significantly associated with rectal tumors and tumors with infiltrative gross appearance, grade III, deeper invasion, and positive lymph node metastases. Also, there was a significant association between both margins' positivity and other pathological parameters as signet ring carcinoma, tumor budding, perineural and vascular invasion, high microvessel density (MVD), and sinusoidal vascular pattern, while the presence of necrosis and infiltrative advancing tumor front was significantly associated with CRM involvement only. The depth of tumor invasion and signet ring carcinoma were identified as independent predictor factors for positive CRM and LRM, respectively.

Conclusion: Preoperative identification of these pathological parameters can be a guide to tailor the management plan accordingly.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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