130例结直肠癌癌周间隙的出现与预后关系的回顾性分析

Relationship between peritumor retraction clefting and prognosis:A retrospective analysis of 130 cases of colorectal carcinoma

目的探讨结直肠普通型腺癌中癌周间隙的出现与脉管侵犯、神经累及及淋巴结转移的关系。方法收集2016年4月—2019年12月经病理确诊的196例结直肠普通型腺癌患者的病理资料,并对其癌周间隙、脉管侵犯、神经受累、淋巴结转移等进行回顾性分析。按照第4版消化系统肿瘤WHO分类标准复核诊断,并将其分为两组:无癌周间隙组66例和有癌周间隙组130例。有癌周间隙组根据癌周间隙范围的大小再进一步分为两组:≥20%组,共42例;<20%组,共88例。采用SPSS 19.0统计软件分析各组与脉管侵犯、神经累及及淋巴结转移的关系。结果有癌周间隙组比无癌周间隙组脉管侵犯、神经累及、淋巴结转移概率大,差异有统计学意义;在无脉管侵犯的患者中,有癌周间隙的病例比无癌周间隙的病例发生淋巴结转移的概率高(P<0.05),但低于既有脉管侵犯又有癌周间隙的病例(P<0.05),与癌周间隙范围的大小无关(P>0.05)。结论结直肠腺癌中癌周间隙的出现与脉管侵犯、神经累及、淋巴结转移呈正相关,提示预后不良。

Objective To investigate the relationships of peritumor retraction clefting with vascular invasion,nerve involvement,and lymph node metastasis in common colorectal adenocarcinoma.Methods The clinicopathological data of 196 patients with common colorectal adenocarcinoma who were pathologically diagnosed from April 2016 to December 2019 were retrieved,and their clinicopathological features such as peritumor retraction clefting,vascular invasion,nerve involvement,and lymph node metastasis were retrospectively analyzed.The diagnosis was reviewed according to the fourth edition of WHO classification of gastrointestinal tumors,and the patients were divided into two groups:66 cases of non-peritumor retraction clefting and 130 cases of peritumor retraction clefting.The peritumor retraction clefting group was further divided into two subgroups according to extent of retraction clefts:≥20%retraction clefts,42 cases;<20%retraction clefts,88 cases.SPSS 19.0 statistical software was used to analyze the relationships with vascular invasion,nerve involvement,and lymph node metastasis in each group.Results The peritumor retraction clefting group had significantly higher incidence rates of vascular invasion,nerve involvement,and lymph node metastasis than the non-peritumor retraction clefting group(P<0.05).The peritumor retraction clefting group without vascular invasion had a higher incidence of lymph node metastasis than the nonperitumor retraction clefting group without vascular invasion(P<0.05),but lower than the peritumor retraction clefting group with vascular invasion(P<0.05),and had no relationship with the extent of peritumor retraction clefts(P>0.05).Conclusion The appearance of peritumor retraction clefting in colorectal adenocarcinoma is positively correlated with vascular invasion,nerve involvement,and lymph node metastasis,indicating a poor prognosis.