细胞角蛋白染色检测局部晚期食管癌新辅助放化疗后食管切除术患者残留病变

M. Chadha, C. LeVea, T. Mashtare, G. Wilding, M. Javle, C. Nwogu
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引用次数: 0

摘要

根据标准苏木精和伊红染色(CPR- he), 30%的局部晚期食管癌患者接受新辅助放化疗(neo-CRT)达到完全病理缓解(CPR)。关于心肺复苏- he的预后价值存在争议。免疫组织化学染色可用于检测此类患者细微的显微残留病变。我们进行这项研究是为了验证这一假设。18例连续实现心肺复苏的患者被确认。7例患者细胞角蛋白染色阳性;3例有显微残留疾病,在原始苏木精-伊红切片上未发现。7例细胞角蛋白染色阳性的患者中有3例(43%)出现全身复发(60%的患者出现全身复发)。细胞角蛋白染色可作为常规血精-伊红染色的辅助手段,用于鉴别此类患者的残留肿瘤。然而,CPR-CK的预后意义需要在一个大的队列中得到验证。
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Cytokeratin Staining to Detect Residual Disease in Patients Undergoing Neoadjuvant Chemoradiation followed by Esophagectomy for Locally Advanced Esophageal Cancer
Thirty percent of patients undergoing neoadjuvant chemoradiation therapy (neo-CRT) for locally advanced esophageal cancer achieve a complete pathologic response (CPR) based on standard Hematoxylin and Eosin staining (CPR-HE). There is controversy regarding the prognostic value of CPR-HE. Immunohistochemical staining may be useful to detect subtle microscopic residual disease in such patients. We undertook this present study to test this hypothesis. Eighteen consecutive patients who achieved CPR-HE were identified. Seven patients had positive cytokeratin staining; three had microscopic residual disease that was not identified on original hematoxylin-eosin sections. Three of the seven patients (43%) with positive cytokeratin staining had systemic relapse (60 % of patients with systemic relapse).Cytokeratin staining could be a useful adjunct to routine hemaoxylin-eosin staining to identify residual tumor in such patients. The prognostic significance of CPR-CK, however, needs to be validated in a large cohort.
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