结直肠原位癌转移和复发的可能性:对 1069 例患者的回顾性分析

IF 3.3 3区 医学 Q2 ONCOLOGY
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引用次数: 0

摘要

背景大肠原位癌的特点是癌变局限于粘膜内层,或称为上皮内癌,传统上认为这种癌没有区域淋巴结转移的风险。然而,区域淋巴结转移、局部复发和远处转移的个别病例挑战了这一假设。本研究旨在评估结直肠原位癌区域淋巴结转移和复发的发生率。方法对 1994 年 1 月至 2020 年 12 月间因结直肠原位癌接受全层局部切除术或根治术的 1069 例患者进行了回顾性分析。组织病理学特征由两名经验丰富的病理学家进行评估。对疑似复发病例的评估包括腹部-盆腔和胸部计算机断层扫描或 PET-CT。其中,9 名患者被诊断为区域淋巴结转移或癌症复发。其中,4 名患者在初次手术中被诊断为淋巴结转移;2 名患者出现区域淋巴结转移,2 名患者同时出现区域和远处淋巴结转移。另有 2 名患者在原发肿瘤根治术后出现区域淋巴结转移。3 名患者出现了远处转移:1 名患者出现了肝转移,另一名患者出现了肝和肺转移,第三名患者出现了小肠转移。结论与之前的假设相反,结直肠原位癌有可能转移到淋巴结并复发。因此,在诊断时进行仔细评估至关重要,要认识到淋巴结转移或复发的可能性。这种方法对于准确识别癌症复发和确保最佳肿瘤治疗效果至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Potential for Metastasis and Recurrence in Colorectal Carcinoma In Situ: A Retrospective Analysis of 1069 Patients

Background

Colorectal carcinoma in situ, characterized by cancer limited to the intramucosal layer or known as intraepithelial carcinoma, has conventionally considered to be without any risk of regional lymph node metastasis. However, isolated cases of regional lymph node metastasis, local recurrence, and distant metastasis challenge this assumption. This study aimed to assess the occurrence of regional lymph node metastasis and recurrence of colorectal carcinoma in situ.

Methods

A retrospective analysis was conducted in 1069 patients who underwent full-thickness local excision or radical surgery for colorectal carcinoma in situ between January 1994 and December 2020. Histopathological features were assessed by 2 experienced pathologists. In cases of suspected recurrence, evaluation involved abdomen-pelvis and chest computed tomography, or PET-CT.

Results

The recurrence rate of colorectal carcinoma in situ patients was 0.46%. Among the patients, 9 were diagnosed with regional lymph node metastasis or cancer recurrence. Of these, 4 patients were diagnosed with lymph node metastasis during primary surgery; 2 exhibited regional lymph node metastasis, and 2 presented with both regional and distant lymph node metastases. Regional lymph node metastasis occurred in additional 2 patients after radical surgery for the primary tumor. Distant metastasis was observed in 3 patients: hepatic metastasis in 1, hepatic and pulmonary metastases in another, and small bowel metastasis in the third patient. Among the 5 patients experiencing cancer recurrence, 1 expired due to cancer progression.

Conclusion

Contrary to previous assumptions, colorectal carcinoma in situ can potentially metastasize to lymph nodes and recur. Therefore, careful assessment at the time of diagnosis is crucial, recognizing the possibility of lymph node metastasis or recurrence. This approach is essential for accurately identifying instances of cancer recurrence and ensuring optimal oncological outcomes.

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来源期刊
Clinical colorectal cancer
Clinical colorectal cancer 医学-肿瘤学
CiteScore
5.50
自引率
2.90%
发文量
64
审稿时长
27 days
期刊介绍: Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.
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