结肠癌低分化簇分级与临床病理特征和预后关系的研究

Correlation of poorly differentiated cluster grade with clinicopathological features and prognosis of patients with colon cancer

目的:分析和探讨结肠癌低分化簇(poorly differentiated clusters,PDC)分级与临床病理特征和预后的关系。方法:回顾性选取2016年12月至2021年7月于皖西卫生职业学院附属医院接受外科手术治疗的102例结肠癌患者的H&E染色标本及病例资料,复评全部患者肿瘤组织中PDC分级,采用χ~2检验和Logistic回归分析PDC分级与临床病理特征的关系,通过Cox模型评价PDC分级与患者预后的关系。结果:PDC G1为52例,G2 14例,G3 36例。PDC分级与肿瘤出芽(tumor budding,TB)独立正相关,而与肿瘤浸润性淋巴细胞(tumor infiltrating lymphocytes,TIL)独立负相关(均P<0.05)。淋巴结转移或癌结节(HR=2.377,95%CI:1.237~4.568;P=0.009)、远处转移(HR=7.455,95%CI:2.597~21.399;P<0.001)和PDC分级(HR=2.095,95%CI:1.099~3.994;P=0.025)均为结肠癌患者疾病进展的独立风险因素。结论:TIL和TB均可影响结肠癌PDC分级,评估癌组织中PDC分级有助于对结肠癌患者进行预后分层。

Objective To analyze the correlation of poorly differentiated cluster(PDC)grade with clinicopathological features and prognosis of patients with colon cancer.Methods Hematoxylin–eosin-stained specimens and data from 102 patients with colon cancer who underwent surgery at the Affiliated Hospital of Anhui West Health Vocational College between December 2016 and July 2021 were analyzed in this study.The PDC grades of tumor tissues were determined in all colon cancer cases.Additionally,associations between the PDC grade and clinicopathological features of patients were analyzed via Chi-square test and Logistic regression analysis,whereas the association between the PDC grade and patient prognosis was evaluated using Cox regression analysis.Results In total,52 cases were identified as PDC G1,14 as PDC G2,and 36 as PDC G3.Tumor budding(TB)was independently and positively associated with PDC,whereas tumor infiltrating lymphocytes(TIL)were independently and negatively associated with PDC(all P<0.05).Lymph node metastasis or presence of cancerous nodules(hazard ratio[HR]=2.377;95%confidence interval[CI]=1.237–4.568;P=0.009),distant metastasis(HR=7.455;95%CI=2.597–21.399;P<0.001),and the PDC grade(HR=2.095;95%CI=1.099–3.994;P=0.025)were independent risk factors for colon cancer progression.Conclusions Our findings suggest that both TIL and TB affect the colon cancer PDC grade.Therefore,evaluating the PDC grade in cancer tissues can facilitate the prognostic stratification of patients with colon cancer.