Perineural Invasion is a Prognostic Factor in Patients with Colorectal Cancer

腫瘤細胞的神經侵犯是大腸直腸癌病患術後的預後因子

林裕祥(Yu-Hsiang Lin) ； 王煥昇(Huann-Sheng Wang) ； 姜正愷(Jeng-Kae Jiang) ； 林宏鑫(Hung-Hsin Lin) ； 林春吉(Chun-Chi Lin) ； 藍苑慈(Yuan-Tzu Lan) ； 張世慶(Shih-Ching Chang) ； 楊純豪(Shung-Haur Yang) ； 陳維熊(Wei-Shone Chen) ； 林資琛(Tzu-Chen Lin) ； 林楨國(Jen-Kou Lin)

《中華民國大腸直腸外科醫學會雜誌》 30卷4期 (2019/12) Pp. 173-180

https://doi.org/10.6312/SCRSTW.201912_30(4).10812

摘要

Purpose. Identification of prognostic factors in colorectal cancer has taken center stage in recent research, and to improve the survival rate of colorectal cancer in Taiwan and elsewhere, additional studies are required to investigate the prognostic value of perineural invasion in colorectal cancer patients. Methods. From a prospective database in a single medical center, patients with colorectal cancer who had undergone surgical resection between January 2010 and December 2014 were identified. For all subjects, patient characteristics, cancer-specific survival, and overall survival were evaluated. Data from complete pathological reports, including perineural invasion (PNI), round cell infiltration, and infiltrative invasive pattern of cancer tissue, were analyzed. Results. In total, 2582 patients met the eligibility criteria, of which 236 were excluded due to missing clinical or pathological data, and 72 were lost to follow-up. Thus, 2274 patients were included in the analysis. Patients were predominantly male (60.3%) and ≥ 65 years of age (55.1%). Perineural invasion was significantly associated with poor cancer-specific survival (p ＜ 0.001) and overall survival (p ＜ 0.001). There were more patients with perineural invasion in the groups that underwent emergent surgery and with advanced TNM staging (p ＜ 0.001). Pathologic analysis showed that PNI was associated with lymphovascular invasion, isolated cancer nodule at mesentery, and inflammatory change around the cancer (p ＜ 0.001). Conclusion. In CRC patients, PNI was significantly associated with poor cancer-specific survival and overall survival rate. PNI was demonstrated to be an independent prognostic factor in stage II CRC patients. Further molecular studies and treatment strategies are warranted.

關鍵字

Perineural invasion ； Colorectal cancer ； Prognostic factor

並列摘要

目前許多的研究都在探討大腸直腸癌的各項預後因子。本研究旨在評估神經侵犯對於大腸直腸癌患者的臨床預後價值。本篇回顧性研究收錄了2010年至2014年於台北榮民總醫院的大腸直腸癌病患。我們分析了病患的基本資料、整體存活率、及腫瘤特定存活率。另外還收錄了完整的病理資料，包含是否有神經侵犯，圓細胞浸潤，腫瘤組織是否有整體的浸潤侵犯等。我們總共收錄了2274位病患。其中包含1371位男性及903位女性。結果顯示，不論是腫瘤特定存活率及整體存活率，神經侵犯都可以成為大腸直腸癌患者的良好預後因子。尤其是在第二期大腸直腸癌患者。另外，神經侵犯明顯和急診手術以、晚期癌症、圓細胞浸潤、以及整體腫瘤浸潤侵犯等惡性因子有相關性。

並列關鍵字

神經侵犯 ； 結腸直腸癌 ； 預後因子

參考文獻

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