结直肠印戒细胞癌的临床病理特征研究
Clinicopathological characteristics of colorectal signet-ring cell carcinoma(SRCC)
王龙 1武帅 1王炳智 1郑波 1李文斌 1邹霜梅1
作者信息
- 1. 100021 北京,国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院病理科
- 折叠
摘要
目的 印戒细胞癌(SRCC)是结直肠癌中预后极差且临床治疗效果欠佳的特殊亚型.由于相对少见,目前对其临床病理特征尤其是免疫微环境的表达特征尚不清楚.方法 本研究入组中国医学科学院肿瘤医院79例SRCC病例并以156例管状腺癌(TC)病例作为对照组,收集临床病理资料及预后信息,并进行免疫微环境相关的免疫组化标记染色,比较两组差异.结果 与TC组相比,SRCC更多见于≤ 60岁人群(x2=12.35,P＜0.01),发生部位多见于乙状结肠/直肠(x2=10.91,P＜0.01),T分期、N分期及M分期更晚(P值均＜0.01),常见脉管瘤栓(x2=24.16,P＜0.01),预后较差(HR=4.19,P＜0.01),而且进展方式主要以腹腔播散为主而较少发生远处转移.免疫微环境上PD-L1表达低,但巨噬细胞数量显著增多(P值均＜0.01).结论 结直肠SRCC是一种恶性程度高的组织学亚型,具有独特的生物学行为及免疫微环境表达特点.
Abstract
Objective Signet-ring cell carcinoma(SRCC)is a special subtype of colorectal cancer with extremely poor prognosis and poor clinical treatment effect.Due to its relative rarity,the expression signature of its clinicopathological features,especially the immune microenvironment,is currently unknown.Methods In this study,seventy-nine SRCC cases were enrolled in Cancer Hospital Chinese Academy of Medical Sciences and 156 tubular adenocarcinoma(TC)cases were matched.Clinical and pathological data and prognosis information were collected,and immunohistochemical markers related to immune microenvironment were stained to compare the differences between the two groups.Results SRCC was more likely to occur ≤60 years old(x2=12.35,P＜0.01),proximal colon(x2=10.91,P＜0.01).T、N、M stage of SRCC was later(all P＜0.01)and more likely to harbour tumor thrombus(x2=24.16,P＜0.01).The prognosis(PFS)is poor(HR=4.19,P＜0.01),and the mode of SRCC progression is mainly peritoneal dissemination but less distant metastasis.The presence of CD8+T on the immune microenvironmnent showed fewer cells and low PD-L1 expression,but significantly increased numbers of macrophages(all P＜0.01).Conclusion Colorectal SRCC is a highly malignant histological subtype with unique biological behavior and immune microenvironment characteristics.
关键词
结直肠肿瘤/印戒细胞癌/病理/免疫治疗Key words
Colorectal neoplasms/Signet-ring cell carcinoma/Pathology/Immunotherapy引用本文复制引用
出版年
2024
NETL
NSTL
万方数据