翻译肠系膜肿瘤细胞沉积是否应该纳入到小

译者：韩昱晨中国医科大学病理

现代病理学杂志

小肠高分化神经内分泌肿瘤可有肠系膜肿瘤沉积，后者没有被纳入到目前的AJCC小肠神经内分泌肿瘤分期系统中，其对患者预后的影响不详。本研究共计72例小肠神经内分泌肿瘤病例，有切片、报告及随访资料。病例依据T分类、存在肠系膜肿瘤沉积、淋巴结转移、淋巴管血管侵袭和肝转移进行评估。肠系膜肿瘤沉积定义为1mm、不规则生长、与原发灶不相连的结节。

排除明确来自于原发部位的结外播散或者相连续的直接累及。43/72（60%）有肠系膜肿瘤沉积，与手术时淋巴管血管侵袭（p0.)、pT3或pT4(P=0.)、淋巴结转移(P=0.)、肝转移(P0.)显著相关。此外，6例有肿瘤沉积、无淋巴结转移的病例中4例有肝脏转移。肿瘤沉积与疾病进展率高和疾病相关死亡有关(P=0.)。总之，术中见肿瘤沉积与疾病进展率高和疾病相关死亡有关(危险率:4.0;95%可信区间:1.3,12.5;P=0.)。肠系膜肿瘤沉积出现于大多数小肠神经内分泌肿瘤，并提示预后差。因此，肠系膜肿瘤沉积在小肠神经内分泌肿瘤分期中发挥作用，可能与淋巴结转移作用类似。

Shouldmesenterictumordepositsbeincludedinstagingofwell-differentiatedsmallintestineneuroendocrinetumors?

GonzalezRS,LiuEH,AlvarezJR,AyersGD,WashingtonMK,ShiC

ModernPathology；Volume27,Issue9(September):-95

Well-differentiatedsmallintestineneuroendocrinetumorscangiverisetomesenterictumordeposits,whicharenotincludedinthecurrentAmericanJointCommitteeonCancerstagingsystemforsmallintestineneuroendocrinetumors,andtheirimpactonpatientprognosisisunknown.Seventy-twosmallintestineneuroendocrinetumorsresectionswereidentifiedinourfileswithslides,reports,andfollow-updataavailable.CaseswereassessedforT-categoryandforthepresenceofmesenterictumordeposits,lymphnodemetastases,lymphovascularinvasion,andlivermetastases.Mesenterictumordepositsweredefinedasdiscretemesenterictumornodules≥1mmwithanirregulargrowthprofile.

Similarlesionsclearlyresultingfromextranodalextensionordirectcontiguousspreadbytheprimarylesionwereexcluded.Forty-threeofthe72caseshadmesenterictumordeposits(60%).Thedepositsweresignificantlyassociatedwithlymphovascularinvasion(P=0.),pT3orpT4disease(P=0.),nodalmetastases(P=0.),andlivermetastases(P0.)atthetimeofsurgery.Inaddition,fourofsixcaseswithtumordepositsandnonodaldiseasehadliverdisease.Tumordepositswereassociatedwithanincreasedincidenceofdiseaseprogressionanddeathduetothedisease(P=0.).Finally,thepresenceoftumordepositsatthetimeofsurgerywasassociatedwithanincreaseinhazardofprogressionordeathduetodisease(hazardratio:4.0;95%confidenceinterval:1.3,12.5;P=0.).Mesenterictumordepositsarepresentinthemajorityofcasesofsmallintestineneuroendocrinetumorsandareindicatorsofpoorprognosisforthisdisease.Therefore,theymayhaveaplaceinstagingofsmallintestineneuroendocrinetumors,perhapsasanalogoustolymphnodedisease.

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