文章：

结直肠癌原发灶与肺转移灶中促结缔组织增生反应与肿瘤出芽的关系及其预后意义

Relationship of Desmoplastic Reaction and Tumour Budding in Primary and Lung Metastatic Lesions of Colorectal Cancer and Their Prognostic Significance

原文发布日期：8 February 2025

DOI: 10.3390/cancers17040583

类型: Article

开放获取: 是

英文摘要：

Background/Objectives:Histopathological indicators, including desmoplastic reaction (DR) and tumour budding (TB), are significant prognostic indicators for metastatic liver lesions in patients with colorectal cancer (CRC). However, the relationship of DR and TB in primary CRC and metastatic lung lesions and their prognostic significance has not yet been examined. This study aimed to elucidate the association of DR and TB in primary CRC and metastatic lung lesions.Methods:Patients with pT3 or pT4 CRC with lung metastasis who underwent surgical resection of the primary CRC and synchronous or metachronous metastatic lung lesions were enrolled. DR was classified into immature (IM) and non-IM types, and TB was classified into TB1 (<4 buds), TB2 (5–9 buds) and TB3 (≥10 buds) in both the primary CRC and metastatic lung lesions.Results:Overall, 40 patients with CRC (males, 21; females, 19; median age, 70 years; right-side colon, 6; left-side colon, 9; rectum, 25; pT3, 31; pT4, 9) were evaluated. Six and thirty-four patients were classified as having IM and non-IM DR in the metastatic lung lesions, respectively. Thirty-one, seven, and two patients were classified as having TB1, TB2, and TB3, respectively. There was no significant correlation between primary and lung metastatic lesions for DR (κ= 0.08,p= 0.086), whereas TB demonstrated a moderate correlation (κ= 0.47,p= 0.015). The presence of IM DR and TB2/3 in metastatic lung lesions significantly correlated with poor overall survival (p= 0.0020 and 0.044, respectively).Conclusions:histological indicators of metastatic lung lesions in CRC may provide important prognostic information for better patient care.

摘要翻译： 

背景/目的：组织病理学指标，如促结缔组织增生反应（DR）和肿瘤出芽（TB），是结直肠癌（CRC）患者肝转移灶的重要预后指标。然而，DR和TB在原发性CRC与肺转移灶中的关联及其预后意义尚未明确。本研究旨在阐明DR和TB在原发性CRC与肺转移灶之间的关联。方法：纳入pT3或pT4期CRC伴肺转移、并接受原发性CRC及同步或异时性肺转移灶手术切除的患者。在原发性CRC和肺转移灶中，DR分为未成熟型（IM）和非IM型，TB分为TB1（<4个出芽）、TB2（5–9个出芽）和TB3（≥10个出芽）。结果：共评估40例CRC患者（男性21例，女性19例；中位年龄70岁；右半结肠6例，左半结肠9例，直肠25例；pT3期31例，pT4期9例）。肺转移灶中，6例和34例分别被归类为IM型和非IM型DR；31例、7例和2例分别被归类为TB1、TB2和TB3。DR在原发灶与肺转移灶之间无显著相关性（κ=0.08，p=0.086），而TB呈中等程度相关（κ=0.47，p=0.015）。肺转移灶中IM型DR和TB2/3的存在与较差的总生存期显著相关（分别为p=0.0020和0.044）。结论：CRC肺转移灶的组织学指标可为改善患者诊疗提供重要的预后信息。

原文链接：

Relationship of Desmoplastic Reaction and Tumour Budding in Primary and Lung Metastatic Lesions of Colorectal Cancer and Their Prognostic Significance