大腸低分化腺癌の臨床病理学的検討  充実型,非充実型低分化腺癌の分類法の予後因子としての重要性

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  • Clinicopathologic Characteristics of Poorly Differentiated Adenocarcinoma of the Colorectum: Prognostic Significance of Solid and Non-solid Types of Poorly Differentiated Adenocarcinoma.

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AIMS The aim of this work was to clarify clinicopathologic features of poorly differentiated adenocarcinomas of the colorectum, which were especially subclassified into solid and nonsolid types, in comparison with well to moderately differentiated adenocarcinomas.<BR>METHODS A total of 1085 patients with colorectal carcinoma (82 poorly differentiated, 631 well differentiated, and 372 moderatery differentiated adenocarcinomas) that received surgery at Kitasato University East Hospital, between 1986 and 1999, were investigated for clinicopathologic variables. Comparative study was performed between 34 solid type and 48 non-solid type poorly differentiated adenocarcinomas. Data were analyzed by univariate and multivariate statistics. RESULTS Larger tumor and metastases to lymph nodes, liver, or peritoneum were more frequently observed in poorly differentiated type than in other types of adenocarcinomas. Five-year survival was significantly worse in the former (47%) than in the latter (well differentiated type, 75 % ; moderately differentiated type, 66%). Non-solid type poorly differentiated adenocarcinomas frequently showed lymph node liver metastases compared with solid type. Five-year survival was significantly worse in the non-solid type (37 %) than in the solid type (68%). Cox 's logistic regression multivariate analysis showed that non-solid type and older patients (≥66 yrs) were statistically significant worse predictors.<BR>CONCLUSIONS Poorly differentiated adenocarcinomas were aggressive tumors associated with frequent metastases. subclassification of these tumors into non-solid and solid types is an independent prognostic predictor.

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