本期胸小星将为大家带来食管癌瘤周淋巴管与新辅助化疗抵抗和不良生存有关；微创食管切除术后直接经口喂养：一项单中心前瞻性队列研究，一起来看看吧！

1

PeritumoralLymphaticVesselsAssociatedWithResistancetoNeoadjuvantChemotherapyandUnfavorableSurvivalinEsophagealCancer

TakeoHara1,TomokiMakino2,MakotoYamasaki1,KojiTanaka1,KotaroYamashita1,YuyaNogi1,TakuroSaito1,TsuyoshiTakahashi1,YukinoriKurokawa1,MitsuakiTatsumi3,KiyokazuNakajima1,EiichiMorii4,HidetoshiEguchi1,YuichiroDoki

1DepartmentofGastroenterologicalSurgery,GraduateSchoolofMedicine,OsakaUniversity,Suita,Osaka,Japan;

2DepartmentofNuclearMedicineandTracerKinetics,GraduateSchoolofMedicine,OsakaUniversity,Suita,Osaka,

Japan;

3DepartmentofPathology,GraduateSchoolofMedicine,OsakaUniversity,Suita,Osaka,Japan

Background:

Peri-orintra-tumorlymphangiogenesisisinducedinseveraltypesofcancer.However,thesignificanceofperitumorallymphaticvessels(LVs)inesophagealcancer(EC)remainstobeclarified.

Methods:

ThisstudyincludedeligibleECpatientswithorwithoutneoadjuvantchemotherapy(NAC).Thenumbersofnon-tumoralandperitumoralLVswerecountedinresectedspecimensbasedonpodoplaninimmunostaining.TheassociationbetweenperitumoralLVnumberandclinicopathologicparameters,includingtumorheterogeneityasmeasuredbypositronemissiontomography,NACresponse,andpatientsurvivalwereanalyzed.

Results:

Innon-NACpatients,thenumberofperitumoralLVswashighestinthelaminapropriamucosa(LPM),followedbynon-tumoralLVsintheLPM,peritumoralLVsinthesubmucosa(SM),andnon-tumoralLVsintheSM.ThepatientswithalownumberofperitumoralLVsintheLPMversusthosewithahighnumberconstitutedalargerfractionoftheNACpatients(67.8%vs.50.0%;P=0.)andhadapoorerpathologicresponsetoNAC(grades0-1a:68.8%vs.47.2%;P=0.),aswellasgreatertumorheterogeneityandworsesurvival(5-yearoverallsurvival:50.6%vs.72.8%;P=0.).ThenumberofperitumoralLVsintheLPMwasidentifiedasanindependentprognosticfactorwiththehighesthazardratio(HR)ofoverallsurvival(HR2.06;P=0.)inthemultivariateanalysis.

Conclusion:

ForECpatients,peritumoralLVsintheLPMlayerareassociatedwithtumorheterogeneity,responsetoNAC,andunfavorablesurvival.

[CITATION]HaraT,MakinoT,YamasakiM,etal.PeritumoralLymphaticVesselsAssociatedwithResistancetoNeoadjuvantChemotherapyandUnfavorableSurvivalinEsophagealCancer[J].Annalsofsurgicaloncology.

[IF]3.

[DOI]10./s---x

食管癌瘤周淋巴管与新辅助化疗抵抗和不良生存有关

胸“星”外科学术团队成员吴希文译

背景

一些种类的癌症可以诱导肿瘤周围和肿瘤内部的淋巴管生成。然而，瘤周淋巴管（LVs）对食管癌的意义尚未被阐明。

方法

本研究纳入了名符合条件的接受或未接受新辅助化疗（NAC）的EC患者。基于podoplanin免疫染色，在切除标本中统计非肿瘤性和瘤周LVs数量。分析了瘤周LV数目与临床病理参数之间的关系，包括通过正电子发射计算机断层扫描测量肿瘤异质性、NAC反应以及患者生存。

结果

在无NAC反应的患者中，固有层黏膜(LPM)中瘤周LVs数量最多，其次是LPM中的非肿瘤性LVs，黏膜下层（SM）的瘤周LVs，以及SM中的非肿瘤性LVs。LPM中瘤周LVs数量较少的患者在NAC反应患者中所占比例较大(67.8%和50.0%；P=0.），并且对NAC的反应更差(0-1a级:68.8%和47.2%；P=0.），同时其具有更大的肿瘤异质性和更差的生存率(5年总生存率:50.6%和72.8%;P=0.)。在多因素分析中，LPM中瘤周LVs数目被确定为风险比最高的(HR2.06;P=0.)影响总生存的独立预后因素。

结论

对于EC患者，LPM层中的瘤周LVs与肿瘤异质性、对NAC的反应和不良生存相关。

FIG.1Comparisonofalymphaticvessel(LV)numbersin65

patientswithoutneoadjuvantchemotherapyandbperitumoralLV

numbersinthelaminapropriamucosaamongallcases.

食管癌作为我国的高发疾病，其治疗方式及预后生存一直饱受

转载请注明原文网址：http://www.nklmc.com/mbyxg/7789.html