CAJ | 학술논문

目的探讨肿瘤芽孢与T2期直肠癌患者临床病理特征及预后的关系.方法收集2001 -2005年间在上海长海医院接受根治性手术的123例T2期直肠癌患者的临床病理资料,将其直肠癌标本进行切片,行苏木精-伊红染色,通过镜下肿瘤芽孢计数获得芽孢最大值及其平均值.将芽孢最大值及其平均值均分为1级(芽孢数小于或等于5)、2级(芽孢数介于5和10之间)和3级(芽孢数大于或等于10).结果单因素和多因素分析结果显示,芽孢最大值和平均值及淋巴管浸润是淋巴结转移的独立影响因素(P＜0.01).芽孢最大值与肿瘤分化程度和神经浸润有关(P＜0.05和P＜0.01);芽孢平均值与肿瘤分化程度、血管浸润及神经浸润有关(均P＜0.01).芽孢平均值1级、2级和3级患者的平均无瘤生存期分别为110.5、95.8和60.0个月,1级与2、3级比较,差异有统计学意义(P＜0.05)；而2、3级间比较差异无统计学意义(P＞0.05).芽孢最大值1级、2级和3级患者的平均无瘤生存期分别为115.1、98.5和86.0个月,1级与3级和2级与3级比较,差异均有统计学意义(P＜0.01和P＜0.05)；而1级与2级比较,差异无统计学意义(均P＞0.05).结论肿瘤芽孢是评估直肠癌侵袭力的一个较好的指标,对评估预后也有较高的价值.
목적 탐토종류아포여T2기직장암환자림상병리특정급예후적관계.방법 수집2001 -2005년간재상해장해의원접수근치성수술적123례T2기직장암환자적림상병리자료,장기직장암표본진행절편,행소목정-이홍염색,통과경하종류아포계수획득아포최대치급기평균치.장아포최대치급기평균치균분위1급(아포수소우혹등우5)、2급(아포수개우5화10지간)화3급(아포수대우혹등우10).결과 단인소화다인소분석결과현시,아포최대치화평균치급림파관침윤시림파결전이적독립영향인소(P＜0.01).아포최대치여종류분화정도화신경침윤유관(P＜0.05화P＜0.01);아포평균치여종류분화정도、혈관침윤급신경침윤유관(균P＜0.01).아포평균치1급、2급화3급환자적평균무류생존기분별위110.5、95.8화60.0개월,1급여2、3급비교,차이유통계학의의(P＜0.05)；이2、3급간비교차이무통계학의의(P＞0.05).아포최대치1급、2급화3급환자적평균무류생존기분별위115.1、98.5화86.0개월,1급여3급화2급여3급비교,차이균유통계학의의(P＜0.01화P＜0.05)；이1급여2급비교,차이무통계학의의(균P＞0.05).결론 종류아포시평고직장암침습력적일개교호적지표,대평고예후야유교고적개치.
Objective To demonstrate the association of tumor budding with clinicopathological features and prognosis in T2 rectal cancer.Methods Clinicopathological data of 123 patients who underwent potentially curative resection for T2 rectal carcinoma between 2001 and 2005 at the Changhai Hospital were collected.All pathology slides were stained with hematoxlin and eosin for microscopic examinations.The maximum value of tumor buds (MV) and average value of tumor buds (AV) were calculated,which were classified as low value (≤5),median value(5＜bud value＜10),and high value (≥ 10).Results Univariate analysis and multivariate analysis revealed that MV (P=0.000),AV (P=0.001 ),and lymphatic invasion (P=0.006) were independent predictors for lymph node metastasis in T2 rectal cancer.Neural invasion and poorly differentiation were significantly associated with MV (P＜0.05).Neural invasion,vascular invasion and poorly differentiationwere were significantly associated to AV(P＜0.01).Disease-free survival (DFS) of patients with low AV,median AV and high AV was 110.5 months,95.8 months,and 60.0 months respectively.There were significance differences in DFS of low AV with median and high AV (P＜0.05).DFS of patients with low MV,median MV and high MV was 115.1 months,98.5 months,and 86.0 months respectively.There were significance differences in DFS between low and high AV,and median and high MV (P＜0.01 and P＜0.05),while no significant difference existed between low and median MV.Conclusion Tumor budding is a useful marker to indicate high invasiveness of rectal cancer and a valuable prognostic predictor.