摘要
目的探讨肿瘤出芽在胰头癌根治术后评价预后中的作用。方法肿瘤出芽定义为肿瘤浸润前沿的单个或一簇个数<5的肿瘤细胞,200倍显微镜视野下(0.785 mm2)计数肿瘤出芽的个数。回顾性分析2005～2010年67例因胰头癌行根治性切除术患者的临床病理资料及随访资料,对影响预后的临床病理因素进行多因素分析。结果 (1)67例胰头癌患者中肿瘤出芽个数0～59个/0.785 mm2,中位数19个/0.785 mm2。采用接受者运行曲线(ROC)定义肿瘤出芽个数≥17为肿瘤出芽高密度组,<17为肿瘤出芽低密度组。本研究肿瘤出芽高密度组39例(58.2%),低密度组28例(41.8%)。肿瘤出芽高密度组年龄小(P=0.007),T分期高(P=0.007),N分期高(P=0.002),AJCC分期高(P=0.004),神经浸润发生率高(P=0.004),组织学分级高(P=0.001),术后早期复发多(P=0.001),2年生存率低(P=0.000)。(2)存活26例,死亡41例。中位生存时间12个月(3～59个月)。单因素分析结果显示,T分期(P=0.009)、N分期(P=0.003)、AJCC分期(P=0.006)、组织学分级(P=0.034)和肿瘤出芽(P=0.000)与胰头癌患者的生存时间有关,多因素Cox回归分析结果显示,肿瘤出芽高密度是胰头癌患者预后的独立影响因素(HR=3.093,95%CI 1.314～7.283,P=0.010)。结论肿瘤出芽高密度是胰头癌根治性切除术后预后不良的重要因素。
Objective To investigate the role of tumor budding in predicting the prognosis of pancreatic cancer after total resection. Methods Tumor budding was defined as a single or a cluster of tumor cells （ 〈 5 tumor cells） infiltrating the stroma at the invasive front, the number of tumor budding was counted in a × 200 microscopic field （0. 785 mm^2 ）. The clinical, pathological and follow-up data of 67 patients with pancreatic head cancer, who received total resection in our hospital from 2005 to 2010, were enrolled into this study for a multivariate analysis of the predictors 59/0. 785 mm2 , with a median of 19/0. 785 mm^2 in the 67 cases. of the tumor. Results The number of tumor budding was 0 - Based on receiver operation curve （ROC） , the number of tumor budding ≥17 was defined as high-density group （39 cases, 58.2% ） , and 〈 17 was low-density group （28 cases, 41.8% ）. High- density group showed significantly younger age （ P = 0. 007 ） , higher T classification （ P = 0. 007 ）, higher N stage （ P = 0. 002 ） , higher AJCC staging （P = 0. 004）, higher incidence of perineural invasion （ P = 0. 004）, higher G grade （ P = 0. 001 ）, more early recurrence （P = 0. 001 ）, and lower 2-year survival rate （ P = 0. 000） than the low-density group. Totally 26 patients survived, the other 41 died. The median survival time was 12 months （3 to 59 months）. Univariate analysis showed that T classification （P = 0. 009） , N stage （ P = 0. 003 ）, AJCC staging （ P = 0. 006） , G grade （P = 0. 034）, and tumor budding （ P = 0. 000） were related to the survival time of patients with pancreatic head cancer. And Cox regression confirmed that tumor budding was the only independent prognostic factor of pancreatic head cancer （ HR = 3. 093, 95% CI 1. 314 - 7. 283, P = 0. 010）. Conclusions High-density tumor budding is an important negative prognostic factor for pancreatic head cancer.
出处
《中国微创外科杂志》
CSCD
2012年第7期604-607,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
胰腺癌
肿瘤出芽
肿瘤复发
预后
Pancreatic cancer
Tumor budding
Recurrence
Prognosis
