CAJ | 학술논문

目的比较伴神经内分泌成分(neuroendocrine component,NEC)的结直肠腺癌和不伴NEC的结直肠腺癌的预后差异,分析其预后价值.方法回顾性收集病理确诊的结直肠腺癌患者,对石蜡切片进行形态学筛选和神经内分泌标记免疫组化检测.选择伴NEC的腺癌作为病例组(27例).采用1:2配对的方式从结直肠癌数据库中选择临床病理特征与之相配对的不伴NEC的腺癌患者作为对照(54例),对两组患者进行相关预后分析.结果27例伴NEC的腺癌患者中,中位随访时间72个月.伴NEC的腺癌患者接受根治性手术后5年无复发生存率和5年肿瘤相关生存率分别为58.0%和58.3%,而对照组分别为79.1%和81.1%,两者差异有统计学意义(P=0.036和0.037).伴有NEC的腺癌患者5年内出现肿瘤复发或肿瘤导致死亡的风险为不伴NEC腺癌患者的2.38倍和2.41倍.结论结直肠腺癌中的NEC是预后不良的重要因素之一.
목적 비교반신경내분비성분(neuroendocrine component,NEC)적결직장선암화불반NEC적결직장선암적예후차이,분석기예후개치.방법 회고성수집병리학진적결직장선암환자,대석사절편진행형태학사선화신경내분비표기면역조화검측.선택반NEC적선암작위병례조(27례).채용1:2배대적방식종결직장암수거고중선택림상병리특정여지상배대적불반NEC적선암환자작위대조(54례),대량조환자진행상관예후분석.결과27례반NEC적선암환자중,중위수방시간72개월.반NEC적선암환자접수근치성수술후5년무복발생존솔화5년종류상관생존솔분별위58.0%화58.3%,이대조조분별위79.1%화81.1%,량자차이유통계학의의(P=0.036화0.037).반유NEC적선암환자5년내출현종류복발혹종류도치사망적풍험위불반NEC선암환자적2.38배화2.41배.결론 결직장선암중적NEC시예후불량적중요인소지일.
Objective To investigate the differentiation of neuroendocrine component (NEC) in colorectal adenocarcinoma in relation to its significance by comparing the outcome between patients with or without NEC.Methods The paraffin sections from patients with pathologically confirmed colorectal adenocarcinoma were retrospectively collected and screened for those with NEC by morphological examination and immunohistochemistry with neuroendocrine markers.Control patients (n=54) without NEC were selected from colorectal cancer database and 2: 1 matched on the basis of clinical features with NEC positive patients (n=27).Relative analysis was performed between two groups.Results With a median follow-up of 72 months,the 5-year disease free survival was 58.0% (16/27) in NEC positive group and 79.1% (43/54) in control group (P=0.036).Similarly,the 5-year cancer-specific overall survival was significantly lower in NEC positive group than in control group (58.3% versus 81.1%,P=0.037).Cox regression showed that the 5-year cumulative risks of disease recurrence and cancer-caused death in NEC positive patients were 2.38 and 2.41 times higher than those in control patients,respectively.Conclusions NEC appears to bear a poor prognosis in patients with colorectal adenocarcinoma.