肿瘤芽殖与大肠癌生物学行为及预后的关系

目的:探讨肿瘤芽殖强度与大肠癌生物学行为及预后的关系及其临床应用价值.方法:回顾性调查施行根治手术并具有完整临床病理资料的大肠癌94例,分析肿瘤芽殖强度与患者预后及反映大肠癌生物学行为的病理因素间的相关性.结果:肿瘤芽殖强度与淋巴结转移数(P<0.001)、浸润深度(P=0.004)、肿瘤分化(P =0.03)相关;高和低芽殖组间(20% vs 90%),T_2(33% vs 90%)和T_3(26% vs 90%)期,隆起型(33% vs 88%)和溃疡型(18% vs 91%),组织学分级1级(即高分化腺癌)(25% vs 92%)的高、低芽殖组间5a生存率差异具有极显著意义P<0.001);高低芽殖组在肿瘤复发病例分布中有显著性差异(P<0.001).Cox模型分析表明肿瘤芽殖强度是反映大肠癌预后的独立指标之一.结论:肿瘤芽殖强度是反映大肠癌恶性生物学行为和估计预后的良好指标,并具有简单、客观、易操作、较好的可重复性及易于推广应用的特点.

Relationship between tumor budding and prognosis and biological behavior of colorectal cancer

AIM:To investigate the clinical value of the intensity of tumor budding,and to assess the relationship between the intensity of tumor budding and prognosis and biological behavior in colorectal carcinoma. METHODS:The relationship between the inten- sity of tumor budding and prognosis and biolog- ical behavior was retrospectively studied in 94 patients with colorectal cancer who underwent radical excision from January 2000 to December 2001. RESULTS:The intensity of tumor budding cor- related with lymph node metastasis(P<0.001), depth of cancer invasion(P=0.004),and tumor differentiation(P=0.03).Five-year survival rates in different groups were significantly different between high-and low-grade budding(20% vs 90%),the T2(33% vs 90%)and T3(26% vs 90%) phases,and swelling(33% vs 88%)and ulcer(18% vs 91%)types.Further,histological grade I was 25% vs 92% for high-and low-grade budding, respectively.High-and low-grade budding were related to growth and recurrence(P<0.001). Multivariate Cox model analysis showed that the intensity of tumor budding was a significant independent prognostic factor. CONCLUSION:The intensity of tumor budding is an objective,simple and reproducible indica- tor,as well as a good index for estimating prog- nosis and any aggressive biological behavior of colorectal cancer.