【摘要】 目的:确定结直肠癌患者发生周围神经侵犯(peripheral nerve invasion,PNI)的危险因素,并揭示PNI对结直肠癌患者临床预后的影响。方法:选取本院2009年2月至2019年3月行结直肠癌根治术的605例患者临床资料和随访数据。于病理科调取符合入组条件患者的苏木精-伊红染色(hematoxylin-eosin staining, HE)切片,重新读片,根据HE染色判断PNI情况。采用统计学方法分析PNI与各临床病理因素的关系,并对影响结直肠患者总体生存率的相关因素采用单因素和多因素COX回归分析。结果:结直肠癌患者PNI发生率为27.1%(164/605)。结直肠癌患者发生PNI与肿瘤分化程度,淋巴结转移显著相关,低分化肿瘤PNI发生率明显高于中分化及高分化肿瘤,PNI(+)组结直肠癌阳性淋巴结的数量显著高于PNI(-)组(24.79±14.47 vs 20.28±10.76,P=0.006),而与年龄、性别、体质量指数、肿瘤部位、其他恶性肿瘤病史、新辅助化疗、糖尿病病史、T分期、N分期、临床分期及脉管癌栓等相关临床病理指标无明显相关。PNI既不是结直肠癌患者预后不良的危险因素,也不是独立预后因素。PNI(+)组与PNI(-)组患者5年总体生存率及无病生存率相比差异无统计学意义(P=0.727、P=0.472)。结论:结直肠癌患者PNI的发生率与肿瘤分化程度和淋巴结转移显著相关,但它既不是结直肠癌患者预后不良的危险因素,也不是独立预后因素。更多还原

【Abstract】 Objective: To determine risk factors of perineural invasion(PNI) in patients with colorectal cancer, and reveal the impact of PNI on clinical prognosis of patients with colorectal cancer. Methods: Clinical data and follow-up data of 605 patients who underwent radical resection of colorectal cancer in the past 10 years were collected from the follow-up database of our hospital. Hematoxylin-eosin staining(HE) sections of eligible patients who met the criteria for admission were collected from the pathology department and re-read. PNI was judged by HE staining. Statistical methods were used to analyze the relationship between PNI and various clinicopathological factors, and relevant factors affecting the overall survival rate of patients with colorectal cancer. Results: The incidence of PNI in patients with colorectal cancer was 27.1%(164/605). The incidence of PNI in colorectal cancer patients was significantly correlated with the degree of tumor differentiation and lymph node metastasis. The incidence of poorly differentiated tumors was significantly higher than those of intermediately differentiated and highly differentiated tumors. The number of positive lymph nodes in the PNI(+) group was significantly higher than that in the PNI(-) group(24.79±14.47 vs 20.28±10.76, P=0.006). PNI was not related to age, sex, body mass index, location of tumors, history of other malignant tumors, neoadjuvant chemotherapy, history of diabetes mellitus, T stage, N stage, clinical stage and venous tumor thrombus. PNI was neither a risk factor for poor prognosis of patients with colorectal cancer nor an independent prognostic factor. There were no significant differences in 5-year overall survival rate(P=0.727) and disease-free survival rate(P=0.501) between the PNI(-) group and the PNI(-) group. Conclusion: The incidence of PNI in patients with colorectal cancer is significantly correlated with the degree of tumor differentiation and lymph node metastasis, but it is neither a risk factor for poor prognosis nor an independent prognostic factor for patients with colorectal cancer.更多还原