Association Between Colorectal Cancer Primary Features and Liver Metastases Histological Growth Patterns: Inflammation on the Primary Tumor is Associated with Desmoplastic Growth Pattern.

Ana Margarida Abrantes, Rui Caetano-Oliveira, Bárbara Oliveiros, Maria Augusta Cipriano, José Guilherme Tralhão
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Abstract

Background: More than 50% of patients diagnosed with colorectal cancer (CRC) will develop liver metastases (CRCLM), which is the main cause of death for more than 60% of these patients. The aim of this study was to correlate the clinical and pathological characteristics of the primary CRC and CRCLM, with emphasis in predicting the histological growth pattern of the CRCLM.

Methods: Cohort of 73 patients with CRC. Analysis of clinical data and blinded pathological review was performed related with primary tumor and CRCLM features. The analysis was performed in SPSS (version 27) with a significance level of 5%.

Results: A statistically significant association was found between tumor size and metastasis growth pattern (P = .002), with larger tumors giving rise to metastases with a nondesmoplastic growth pattern. Lymphovascular invasion (LVI) was associated with metachronous CRCLM (P = .043). In the absence of LVI, the time required for CRCLM to appear was significantly longer (P = .011). The number of metastases was significantly higher (P = .049) in tumors without LVI when compared to tumors with LVI. There was a statistically significant association between CRC high-grade inflammation and the desmoplastic metastases growth pattern of the CRCLM (P = .017).

Conclusion: The possibility of predicting the CRCLM histological growth pattern resorting to primary CRC characteristics would be useful for proper patient selection for surgery and adapting biological therapies.

结直肠癌原发特征与肝转移组织学生长模式的关系:原发肿瘤的炎症与结缔组织增生生长模式相关。
背景:超过50%的结直肠癌(CRC)患者会发展为肝转移(CRCLM),这是超过60%的结直肠癌患者死亡的主要原因。本研究的目的是将原发性结直肠癌和CRCLM的临床和病理特征联系起来,重点是预测CRCLM的组织学生长模式。方法:对73例结直肠癌患者进行队列研究。对原发肿瘤及CRCLM特征进行临床资料分析及病理盲法检查。采用SPSS (version 27)进行分析,显著性水平为5%。结果:在肿瘤大小和转移生长模式之间发现了统计学上显著的关联(P = 0.002),更大的肿瘤引起转移,而非结缔组织增生模式。淋巴血管侵袭(LVI)与异时性CRCLM相关(P = 0.043)。在没有LVI的情况下,CRCLM出现所需的时间明显更长(P = 0.011)。与有LVI的肿瘤相比,无LVI的肿瘤转移数量显著增加(P = 0.049)。CRC高级别炎症与CRCLM的结缔组织增生转移生长模式有统计学意义(P = 0.017)。结论:根据原发性结直肠癌的特征来预测CRCLM的组织学生长模式,将有助于正确选择患者的手术和适应生物治疗。
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