Histogenesis and prognostic value of myenteric spread in colorectal cancer: a Japanese multi-institutional study

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• 作者：Hideki Ueno (1)
  Kazuo Shirouzu (2)
  Hideyuki Shimazaki (3)
  Hiroshi Kawachi (4)
  Yoshinobu Eishi (4)
  Yoichi Ajioka (5)
  Kiyotaka Okuno (6)
  Kazutaka Yamada (7)
  Toshihiko Sato (8)
  Takaya Kusumi (9)
  Ryoji Kushima (10)
  Masahiro Ikegami (11)
  Motohiro Kojima (12)
  Atsushi Ochiai (12)
  Akihiko Murata (13)
  Yoshito Akagi (2)
  Takahiro Nakamura (14)
  Kenichi Sugihara (15)
  
• 关键词：Colorectal cancer ; Myenteric spread ; Auerbach’s plexus ; Perineural invasion ; The UICC/AJCC TNM classification
• 刊名：Journal of Gastroenterology
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：49
• 期：3
• 页码：400-407
• 全文大小：1,552 KB
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  3. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, editors. AJCC cancer staging manual (Seventh edition). New York: Springer; 2009.
  4. Fujita S, Nakanishi Y, Taniguchi H, Yamamoto S, Akasu T, Moriya Y, et al. Cancer invasion to Auerbach’s plexus is an important prognostic factor in patients with pT3–pT4 colorectal cancer. Dis Colon Rectum. 2007;50:1860-. CrossRef
  5. Ueno H, Hase K, Hashiguchi Y, Ishiguro M, Kajiwara Y, Shimazaki H, et al. Growth pattern in the muscular layer reflects the biological behaviour of colorectal cancer. Colorectal Dis. 2009;11:951-. CrossRef
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  11. Fujita S, Shimoda T, Yoshimura K, Yamamoto S, Akasu T, Moriya Y. Prospective evaluation of prognostic factors in patients with colorectal cancer undergoing curative resection. J Surg Oncol. 2003;84:127-1. CrossRef
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  13. Huh JW, Kim HR, Kim YJ. Prognostic value of perineural invasion in patients with stage II colorectal cancer. Ann Surg Oncol. 2010;17:2066-2. CrossRef
  14. Guillem JG, Chessin DB, Cohen AF, Shia J, Mazumdar M, Enker W, et al. Long-term oncologic outcome following preoperative combined modality therapy and total mesorectal excision of locally advanced rectal cancer. Ann Surg. 2005;241:829-8. CrossRef
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  17. Quah H-M, Chou J, Gonen M, Shia J, Schrag D, Landmann RG, et al. Identification of patients with high-risk stage II colon cancer for adjuvant therapy. Dis Colon Rectum. 2008;51:503-. CrossRef
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• 作者单位：Hideki Ueno (1)
  Kazuo Shirouzu (2)
  Hideyuki Shimazaki (3)
  Hiroshi Kawachi (4)
  Yoshinobu Eishi (4)
  Yoichi Ajioka (5)
  Kiyotaka Okuno (6)
  Kazutaka Yamada (7)
  Toshihiko Sato (8)
  Takaya Kusumi (9)
  Ryoji Kushima (10)
  Masahiro Ikegami (11)
  Motohiro Kojima (12)
  Atsushi Ochiai (12)
  Akihiko Murata (13)
  Yoshito Akagi (2)
  Takahiro Nakamura (14)
  Kenichi Sugihara (15)
  
  1. Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
  2. Department of Surgery, Kurume University Faculty of Medicine, Kurume, Japan
  3. Department of Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan
  4. Department of Human Pathology, Tokyo Medical and Dental University, Tokyo, Japan
  5. Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Course for Molecular and Cellular Medicine, Niigata University, Niigata, Japan
  6. Department of Surgery, Kinki University School of Medicine, Osakasayama, Japan
  7. Department of Surgery, Coloproctology Center, Takano Hospital, Kumamoto, Japan
  8. Department of Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
  9. Department of Surgery, Keiyukai Sappro Hospital, Sapporo, Japan
  10. Department of Pathology, National Cancer Center Hospital, Tokyo, Japan
  11. Department of Pathology, Jikei University School of Medicine, Tokyo, Japan
  12. Pathology Division, Research Center for Innovative Oncology National Cancer Center Hospital East, Kashiwa, Japan
  13. Department of Surgery, Hirosaki University School of Medicine, Hirosaki, Japan
  14. Laboratory for Mathematics, National Defense Medical College, Tokorozawa, Japan
  15. Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
  
• ISSN：1435-5922

文摘

Background The histogenesis of the pattern of cancer spread along Auerbach’s plexus (myenteric spread: MS) remains unclear and its prognostic value in colorectal cancer (CRC) has not been thoroughly investigated. Methods Pathology slides of 2845 pT2/pT3/pT4 CRCs stained with hematoxylin–eosin (H&E) were reviewed at 10 institutions. MS was classified into 2 groups depending on whether it was accompanied by the finding of perineural invasion (PN) within the lesion. In addition, immunohistochemical staining (D2-40, S100, CD56, synaptophysin) was performed for serially sectioned specimens from 50 CRCs diagnosed as having PN-negative MS. Results MS was observed in 504 patients (17.7?%); 360 patients were classified as having PN-positive MS and 144 as having PN-negative MS. The 5-year disease-free survival rate of patients with MS was lower than that of patients without MS (63.3 vs 82.7?%, P?<?0.0001); however, there was no significant difference in survival outcome according to the presence or absence of intralesion PN in MS. Multivariate analysis showed that the prognostic impact of MS was independent of conventional prognosticators including T and N stages, vascular invasion and extramural PN. In all the tumors having PN-negative MS, remnants of neural tissue were identified within or around cancer nests located at the leading edge of MS. Conclusions MS is an important prognostic factor for CRC. This feature is the result of cancer development with replacement of Auerbach’s plexus and can be classified as intramural PN. The clinical significance of “Pn1-in the UICC/AJCC TNM classification could be enhanced by individual assessment both intramurally and extramurally.