伴神经内分泌成分的结直肠腺癌预后分析

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.

Prognostic analysis of neuroendocrine component in colorectal adenocarcinoma

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.