上海交通大学学报（医学版）

上海交通大学学报（医学版） >

2022 , Vol. 42 >Issue 8: 1070 - 1080

DOI: https://doi.org/10.3969/j.issn.1674-8115.2022.08.012

论著 · 临床研究

神经脉管浸润联合肿瘤间质比对结直肠癌预后的预测价值

  • 邱佳辉 ,
  • 蔡谦谦 ,
  • 杨彦 ,
  • 程非池 ,
  • 裘正军 ,
  • 黄陈
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  • 1.南京医科大学附属上海一院临床医学院，上海 211166
    2.上海交通大学医学院附属第一人民医院胃肠外科，上海 201600
邱佳辉（1993—），男，硕士生；电子信箱：1326880749@qq.com。
黄 陈，电子信箱：richard-hc@hotmail.com。
裘正军，电子信箱：qiuzjdoctor@sina.com

收稿日期: 2022-03-11

  录用日期: 2022-07-21

  网络出版日期: 2022-10-08

基金资助

国家自然科学基金面上项目(82072662);上海申康医院发展中心临床三年行动计划(SHDC2020CR4022);上海市教育委员会高峰高原学科建设计划(20191425);CSCO-青年创新肿瘤研究基金项目(Y-Young2020-0458)

收起

Value of combined perineural lymphovascular invasion and tumor-stroma ratio in guiding the prognosis of colorecatal cancer

  • Jiahui QIU ,
  • Qianqian CAI ,
  • Yan YANG ,
  • Feichi CHENG ,
  • Zhengjun QIU ,
  • Chen HUANG
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  • 1.Nanjing Medical University of Shanghai General Hospital, Shanghai 211166, China
    2.Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201600, China
HUANG Chen, E-mail: richard-hc@hotmail.com.#Corresponding authors.
QIU Zhengjun, E-mail: qiuzjdoctor@sina.com

Received date: 2022-03-11

  Accepted date: 2022-07-21

  Online published: 2022-10-08

Supported by

National Natural Science Foundation of China(82072662);Clinical Research Plan of SHDC(SHDC2020CR4022);Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20191425);CSCO-Youth Innovation Oncology Research Foundation(Y-Young2020-0458)

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摘要

目的·探讨肿瘤间质比（tumor-stroma ratio，TSR）、神经浸润（perineural invasion，PNI）、脉管浸润（lymphovascular invasion，LVI）对结直肠癌（colorectal cancer，CRC）患者预后的预测价值。方法·回顾性分析2014年1月—2018年12月在上海交通大学医学院附属第一人民医院确诊为CRC的948例患者资料，按病理高危因素TSR、PNI、LVI分为高风险组（n=81）和低风险组（n=867），经SPSS软件进行1∶1病例匹配后得到高风险组67例。低风险组67例，比较高风险组患者和低风险组患者的总生存时间（overall survival，OS），并使用该课题组106例结直肠癌组织芯片（tissue microarray，TMA）数据进行验证。比较高风险组和低风险组的临床特点，采用Kaplan-Meier法进行生存分析，COX回归模型分析影响预后的因素。结果·与低风险组患者中位OS（31.1个月）相比，高风险组患者中位OS（27.7个月）缩短，预后更差（P=0.000）。经过配对后发现具有神经脉管浸润阳性联合高肿瘤间质比特征对预测CRC预后的价值更大，并且在TMA数据中也得到了验证。结论·神经脉管浸润阳性联合高TSR的CRC是一类预后不良的CRC，可以弥补肿瘤-淋巴结-转移（tumor-node-metastasis，TNM）病理分期系统对预后预测的缺陷，可以用于预估CRC患者术后病情发展及指导治疗。

关键词： 结直肠癌; 预后; 病理; 神经浸润; 脉管浸润; 肿瘤间质比

本文引用格式

邱佳辉 , 蔡谦谦 , 杨彦 , 程非池 , 裘正军 , 黄陈 . 神经脉管浸润联合肿瘤间质比对结直肠癌预后的预测价值[J]. 上海交通大学学报（医学版）, 2022 , 42(8) : 1070 -1080 . DOI: 10.3969/j.issn.1674-8115.2022.08.012

Abstract

Objective ·To explore the prognosis effects of tumor-stroma ratio(TSR), perineural invasion (PNI) and lymphovascular invasion (LVI) on patients with colorectal cancer (CRC). Methods ·Data of 948 patients diagnosed with CRC in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from January 2014 to December 2018 were retrospectively analyzed, and according to pathological risk factors TSR, PNI and LVI, patients were divided into high risk group (n=81) and low risk group (n=867). After 1∶1 matching with SPSS software, 67 patients of the high risk group and 67 patients of the low risk group were obtained. The overall survival (OS) time was compared between patients in the high risk group and low risk group. The results were validated by using tissue microarray (TMA) dataset of 106 CRC patients from our research group. The clinical characteristics of the high risk group and low risk group were compared. Kaplan-Meier curve was used for survival analysis, and COX regression model was used to analyze the prognosis factors. Results ·Patients in the high risk group had a worse prognosis with a short median OS (27.7 months) than patients in the low risk group (31.1 months, P=0.000). The worse OS in patients with high risk group was validated in matched data and TMA dataset. Conclusion ·CRC with positive perineural lymphovascular invasion combined with high TSR is a type of CRC with poor prognosis, which can effectively make up for the defect of tumor-node-metastasis (TNM) stage in prognosis and can be used to predict postoperative disease development of CRC patients and guide treatment.

Key words： colorectal cancer; prognosis; pathology; perineural invasion; lymphovascular invasion; tumor-stroma ratio

参考文献

1 SUNG H, FERLAY J, SIEGEL R L, et al. Global cancer statistics 2020: globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249.
2 ZHENG R S, ZHANG S W, ZENG H M, et al. Cancer incidence and mortality in China, 2016[J]. J Natl Cancer Cent, 2022, 2(1): 1-9.
3 YUAN H, DONG Q J, ZHENG B A, et al. Lymphovascular invasion is a high risk factor for stage Ⅰ/Ⅱ colorectal cancer: a systematic review and meta-analysis[J]. Oncotarget, 2017, 8(28): 46565-46579.
4 JIANG H H, ZHANG Z Y, WANG X Y, et al. Prognostic significance of lymphovascular invasion in colorectal cancer and its association with genomic alterations[J]. World J Gastroenterol, 2019, 25(20): 2489-2502.
5 KNIJN N, MOGK S C, TEERENSTRA S, et al. Perineural invasion is a strong prognostic factor in colorectal cancer: a systematic review[J]. Am J Surg Pathol, 2016, 40(1): 103-112.
6 CONTE G A, QARI O, FASANO G A, et al. S100 staining adds to the prognostic significance of the combination of perineural invasion and lymphovascular invasion in colorectal cancer[J]. Appl Immunohistochem Mol Morphol, 2020, 28(5): 354-359.
7 MESKER W E, JUNGGEBURT J M C, SZUHAI K, et al. The carcinoma-stromal ratio of colon carcinoma is an independent factor for survival compared to lymph node status and tumor stage[J]. Cell Oncol, 2007, 29(5): 387-398.
8 LUO Z, FU Z M, LI T F, et al. Development and validation of the individualized prognostic nomograms in patients with right- and left-sided colon cancer[J]. Front Oncol, 2021, 11: 709835.
9 李腾飞, 杨彦, 黄陈. 肿瘤间质比在Ⅱ、Ⅲ期结直肠癌患者预后评估中的价值[J]. 中华结直肠疾病电子杂志, 2021, 10(2): 158-163.
9 LI T F, YANG Y, HUANG C. The prognostic value of tumor stroma ratio in patients with stageⅡand Ⅲ colorevtal caner[J]. Chin J Colorec Dis ( Electronic Edition ), 2021, 10(2): 158-163.
10 NASO J R, YANG H M, SCHAEFFER D F. Variability in synoptic reporting of colorectal cancer pT4a category and lymphovascular invasion[J]. Arch Pathol Lab Med, 2021, 145(3): 343-351.
11 ALOTAIBI A M, LEE J L, KIM J, et al. Prognostic and oncologic significance of perineural invasion in sporadic colorectal cancer[J]. Ann Surg Oncol, 2017, 24(6): 1626-1634.
12 LI T F, YU Z K, YANG Y, et al. Rapid multi-dynamic algorithm for gray image analysis of the stroma percentage on colorectal cancer[J]. J Cancer, 2021, 12(15): 4561-4573.
13 LIZARDO D Y, KUANG C Y, HAO S S, et al. Immunotherapy efficacy on mismatch repair-deficient colorectal cancer: from bench to bedside[J]. Biochim Biophys Acta Rev Cancer, 2020, 1874(2): 188447.
14 蔡建, 王磊. 回眸2018: 聚焦结直肠癌研究领域[J]. 中华胃肠外科杂志, 2019, 22(1): 9-16.
14 CAI J, WANG L. Focus on colorectal cancer research, 2018[J]. Chin J Gastrointest Surg, 2019, 22(1): 9-16.
15 DIENSTMANN R, MASON M J, SINICROPE F A, et al. Prediction of overall survival in stage Ⅱ and Ⅲ colon cancer beyond TNM system: a retrospective, pooled biomarker study[J]. Ann Oncol, 2017, 28(5): 1023-1031.
16 ZHANG C C, WANG Z, YANG Z, et al. Phase Ⅰ escalating-dose trial of CAR-T therapy targeting CEA+ metastatic colorectal cancers[J]. Mol Ther, 2017, 25(5): 1248-1258.
17 THOMSEN M, SKOVLUND E, SORBYE H, et al. Prognostic role of carcinoembryonic antigen and carbohydrate antigen 19-9 in metastatic colorectal cancer: a BRAF-mutant subset with high CA 19-9 level and poor outcome[J]. Br J Cancer, 2018, 118(12): 1609-1616.
18 ZHU G M, PEI L J, XIA H W, et al. Role of oncogenic KRAS in the prognosis, diagnosis and treatment of colorectal cancer[J]. Mol Cancer, 2021, 20(1): 143.
19 YOTHERS G, O'CONNELL M J, ALLEGRA C J, et al. Oxaliplatin as adjuvant therapy for colon cancer: updated results of NSABP C-07 trial, including survival and subset analyses[J]. J Clin Oncol, 2011, 29(28): 3768-3774.
20 BENSON A B, VENOOK A P, AL-HAWARY M M, et al. NCCN guidelines insights: colon cancer, version 2.2018[J]. J Natl Compr Canc Netw, 2018, 16(4): 359-369.
21 LABIANCA R, NORDLINGER B, BERETTA G D, et al. Early colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up[J]. Ann Oncol, 2013, 24(Suppl 6): vi64-vi72.
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