通过免疫染色诊断的浸液细胞学可能是病理Ⅲ期结直肠癌的不良预后因素

IF 2.9 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of Gastroenterological Surgery Pub Date : 2024-10-01 DOI:10.1002/ags3.12863

Akitoshi Nankaku, Yusuke Yamaoka, Akio Shiomi, Hiroyasu Kagawa, Shoichi Manabe, Takuma Oishi, Kiyoshi Tone, Akifumi Notsu, Yusuke Kinugasa

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引用次数: 0

摘要

目的探讨免疫染色诊断的灌洗细胞学阳性对病理性III期结直肠癌（CRC）根治性切除术后远期预后的影响。方法回顾性分析2005年至2017年病理性III期原发性结直肠癌同时行根治性切除术和术中灌洗细胞学检查（LCY）的患者。所有LCY标本采用Papanicolaou染色和癌胚抗原和Ber-EP4免疫染色进行评价。只有通过两种染色方法诊断出的V级才被定义为LCY阳性，并将患者分为两组：灌洗细胞学阳性（LCY+）组；灌洗细胞学阴性（LCY−）组。比较两组患者总生存期（OS）和无复发生存期（RFS）。通过多因素分析确定影响OS和RFS的临床病理因素。结果708例病理性III期结直肠癌患者中LCY阳性30例（4.2%）。LCY（+）组的OS和RFS明显低于LCY（-）组。LCY（+）组和LCY（-）组5-y OS率分别为58.7%和91.0%，5-y RFS率分别为28.8%和76.6%。多因素分析显示，LCY阳性与较低的OS和RFS独立相关。LCY（+）组Papanicolaou染色阴性但免疫染色阳性的比例为20.0%（6 / 30）。与Papanicolaou染色和免疫染色均阳性的患者相比，OS和RFS无明显差异。结论免疫染色诊断的LCY阳性可能是病理性III期结直肠癌预后不良的因素。

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Lavage cytology diagnosed by immunostaining may be a poor prognostic factor in pathological stage III colorectal cancer

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Lavage cytology diagnosed by immunostaining may be a poor prognostic factor in pathological stage III colorectal cancer

Aim

To clarify the prognostic impact of positive lavage cytology diagnosed by immunostaining on long-term outcomes following curative resection for pathological stage III colorectal cancer (CRC).

Method

We retrospectively investigated patients who underwent radical resection and intraoperative lavage cytology (LCY) simultaneously for pathological stage III primary CRC between 2005 and 2017. All LCY specimens were evaluated by Papanicolaou staining and immunostaining for carcinoembryonic antigen and Ber-EP4. Only Class V diagnosed by either staining method was defined as positive LCY, and patients were classified into two groups: a positive lavage cytology (LCY+) group; and a negative lavage cytology (LCY−) group. Overall survival (OS) and relapse-free survival (RFS) were compared between groups. Multivariate analysis was performed to identify clinicopathological factors affecting OS and RFS.

Results

Among 708 patients with pathological stage III CRC, 30 patients (4.2%) showed positive LCY. OS and RFS were significantly lower in the LCY(+) group than in the LCY(−) group. Five-y OS rates in the LCY(+) and LCY(−) groups were 58.7% and 91.0%, respectively, and 5-y RFS rates were 28.8% and 76.6%, respectively. Multivariate analysis revealed that positive LCY was independently associated with lower OS and RFS. In the LCY(+) group, the proportion of patients with negative Papanicolaou staining but positive immunostaining was 20.0% (6 of 30). No significant differences in OS and RFS were evident between those patients and patients with positive results for both Papanicolaou staining and immunostaining.