Prognostic value of elastic lamina staining in patients with stage III colon cancer

World Journal of Surgical Oncology

Research

Zekun Wang¹  Xiaoyan Li²  Yong Zhang²  Deyu Sun³  Qian Dong⁴  Feifei Bi⁴  Jingdong Zhang⁴ 

[1] Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China;Department of Pathology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China;Department of Radiation Oncology Gastrointestinal and Urinary and Musculoskeletal Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China;Medical Oncology Department of Gastrointestinal Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China;

关键词: Colon cancer;    Elastic lamina staining;    Elastic lamina invasion;    Disease-free survival;    Recurrence risk;   

DOI  :  10.1186/s12957-022-02865-y

 received in 2022-07-08, accepted in 2022-12-04,  发布年份 2022

来源: Springer

【 摘 要 】

ObjectiveThe objectives of this study were to analyze the difference between the preoperative radiological and postoperative pathological stages of colorectal cancer (CRC) and explore the feasibility of elastic lamina invasion (ELI) as a prognostic marker for patients with stage III colon cancer.MethodsA total of 105 consecutive patients underwent radical surgery (R0 resection) for stage III colon cancer at the Cancer Hospital of China Medical University between January 2015 and December 2017. Clinicopathological features, including radiological stage and elastic lamina staining, were analyzed for prognostic significance in stage III colon cancer.ResultsA total of 105 patients with stage III colon cancer who met the criteria and had complete data available were included. The median follow-up period of survivors was 41 months. During the follow-up period, 33 (31.4%) patients experienced recurrence after radical resection, and the 3-year disease-free survival (DFS) rate was 64.8%. The consistency between preoperative radiological and postoperative pathological staging was poor (κ = 0.232, P < 0.001). The accuracy of ≤ T2 stage diagnoses was 97.1% (102/105), that of T3 stage was 60.9% (64/105), that of T4a stage was 68.6% (72/105) and that of T4b stage was 91.4% (96/105). The DFS rate of T3 ELI (+) patients was significantly lower than that of both T3 ELI (−) patients (P = 0.000) and pT4a patients (P = 0.013). The DFS rate of T3 ELI (−) patients was significantly higher than that of pT4b patients (P=0.018). T3 ELI (+) (HR (Hazard ratio), 8.444 [95% CI, 1.736–41.067]; P = 0.008), T4b (HR, 57.727[95% CI, 5.547-600.754]; P = 0.001), N2 stage (HR, 10.629 [95% CI, 3.858–29.286]; P < 0.001), stage III (HR, 0.136 [95% CI, 0.31–0.589]; P = 0.008) and perineural invasion (PNI) (HR, 8.393 [95% CI, 2.094–33.637]; P = 0.003) were independent risk factors for postoperative recurrence of stage III colon cancer.ConclusionsThe consistency between preoperative radiological and postoperative pathological staging was poor, especially for tumors located in the ascending colon and descending colon. Elastic lamina staining is expected to become a stratified indicator of recurrence risk for patients with stage III colon cancer and a guide for individualized adjuvant chemotherapy, thus improving patient prognosis.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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Fig. 1

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