切换至 "中华医学电子期刊资源库"

中华结直肠疾病电子杂志 ›› 2016, Vol. 05 ›› Issue (04) : 309 -314. doi: 10.3877/cma.j.issn.2095-3224.2016.04.006

所属专题: 文献

青年专家论坛

病理医师积极参与结直肠癌多学科专家诊疗团队
陈琼荣1, 魏少忠2,()   
  1. 1. 430079 武汉,湖北省肿瘤医院病理科
    2. 湖北省肿瘤医院胃肠肿瘤外科
  • 收稿日期:2016-05-30 出版日期:2016-08-25
  • 通信作者: 魏少忠
  • 基金资助:
    湖北省卫生厅重点资助项目(No.JX6A06); 湖北省自然科学基金重点资助项目(No.2013CFA078); 湖北省自然科学基金资助项目(No.2013CFC022)

Pathologists actively participate in colorectal cancer multidisciplinary team

Qiongrong Chen1, Shaozhong Wei2,()   

  1. 1. Department of Pathology, Hubei Cancer Hospital, Wuhan 430079, China
    2. Department of Gastrointestinal Surgical Oncology, Hubei Cancer Hospital, Wuhan 430079, China
  • Received:2016-05-30 Published:2016-08-25
  • Corresponding author: Shaozhong Wei
  • About author:
    Corresponding author: Wei Shaozhong, Email:
引用本文:

陈琼荣, 魏少忠. 病理医师积极参与结直肠癌多学科专家诊疗团队[J]. 中华结直肠疾病电子杂志, 2016, 05(04): 309-314.

Qiongrong Chen, Shaozhong Wei. Pathologists actively participate in colorectal cancer multidisciplinary team[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2016, 05(04): 309-314.

多学科专家组(multidisciplinary team,MDT)模式能有效的诊治肿瘤患者,也是全球处理结直肠癌的最有效的一种模式。病理医师以MDT核心成员的身份积极参与MDT例会,并不断优化病理科的工作、提高病理专业水平。在十年的MDT临床实践中,病理医师既给患者提供更精准的诊断,也使临床医师据此给患者制定更好的诊疗方案,同时也促进自身病理诊断和科研水平的提高。因此,MDT这一模式值得我们向广大肿瘤医务工作者积极推广。

Multidisciplinary team (MDT) is an effective treatment worldwide for tumor patients, including that of colorectal cancer. Pathologists, as core members of the MDT, actively participate in the regular meeting, which can optimize our routine works and increase our professional level. During ten years of clinic practice of the MDT, the pathologists not only provide accurate diagnoses for the patients but also increase themselves′ diagnostic and research level. According to our precise diagnosis report, the clinicians make a personalized treatment for the colorectal cancer patient. So we think the MDT mode is worthy to be popularized among oncologic workers.

图1 患者,女,64岁,横结肠浆肌层低分化腺癌伴坏死,免疫组化证实为高级别浆液性癌累及横结肠。A癌组织呈实片状或筛状生长,胞浆嗜双色性呈紫蓝色,核浆比大,核仁明显,核分裂象多见(HE,×200);B免疫组化PAX-8核阳性,支持苗勒氏管来源(IHC,×40);C免疫组化P53过表达,提示P53基因突变,支持浆液性癌(IHC,×100);D免疫组化Calretinin阴性,不支持间皮来源(IHC,×40)
[1]
Grass C, Umansky R. Problems in promoting the growth of multi-disciplinary diagnostic and counseling clinics for mentally retarded children in nonmetropolitan areas[J]. Am J Public Health, 1971, 61(4):698-710.
[2]
Poulton BC, West MA. Effective multidisciplinary teamwork in primary health care[J]. J Adv Nurs, 1993, 18(6):918-925.
[3]
王哲,王瑞安. 译. 外科病理取材图解指南, 第二版[M]. 西安:第四军医大学出版社, 2009: 70-75.
[4]
Edge SB, Byrd SR, Compton CC, et al. AJCC Cancer Staging Manual, 7th edition[M]. New York: Springer-Verlag, 2010: 143-164.
[5]
杨凯,侯远发,宋耀明, 等. 直肠癌新辅助治疗后手术标本的淋巴结检出[J]. 中国实用医药, 2014,(11):79-80.
[6]
顾晋,王林. 中低位直肠癌环周切缘的规范化检测及研究进展[J]. 中华胃肠外科杂志, 2011, 14(4):229-233.
[7]
王林,顾晋. 结直肠癌的规范化病理诊断要点[J]. 中华胃肠外科杂志, 2012, 15(10):1088-1091.
[8]
叶颖江,申占龙,王杉. 结直肠癌多学科专家组诊疗模式[J]. 医学与哲学, 2010, 31(3):14-16.
[9]
蔡三军. 结直肠癌的规范性多学科治疗[J]. 中华胃肠外科杂志, 2010, 13(4):245-246.
[10]
中华医学会消化内镜学分会病理学协作组. 中国消化内镜活组织检查与病理学检查规范专家共识(草案)[J]. 中华消化内镜杂志, 2014, 31(9):481-548.
[11]
陈光勇,黄受方,石晓燕, 等. 内镜下胃黏膜切除标本病理学规范化检查的建议[J]. 中华病理学杂志, 2014, 43(5):344-347.
[12]
刘鹏军,葛亚强,王晓燕, 等. 内镜下黏膜下层剥离术治疗上消化道黏膜高级别上皮内瘤变的价值及术后病理分析[J]. 胃肠病学和肝病学杂志, 2015, 24(12):1433-1436.
[13]
Haggitt RC, Glotzbach RE, Soffer EE, et al. Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy[J]. Gastroenterology, 1985, 89(2):328-336.
[14]
Dixon MF. Gastrointestinal epithelial neoplasia: Vienna revisited[J]. Gut, 2002, 51(1):130-131.
[15]
Kazama S, Watanabe T, Ajioka Y, et al. Tumour budding at the deepest invasive margin correlates with lymph node metastasis in submucosal colorectal cancer detected by anticytokeratin antibody CAM5.2[J]. Br J Cancer, 2006, 94(2):293-298.
[16]
Ruzzo A, Graziano F, Canestrari E, et al. Molecular predictors of efficacy to anti-EGFR agents in colorectal cancer patients[J]. Curr Cancer Drug Targets, 2010, 10(1):68-79.
[17]
Allegra CJ, Rumble RB, Hamilton SR, et al. Extended RAS Gene Mutation Testing in Metastatic Colorectal Carcinoma to Predict Response to Anti-Epidermal Growth Factor Receptor Monoclonal Antibody Therapy: American Society of Clinical Oncology Provisional Clinical Opinion Update 2015[J]. J Clin Oncol, 2016, 34(2):179-185.
[18]
Niessen RC, Berends MJ, Wu Y, et al. Identification of mismatch repair gene mutations in young patients with colorectal cancer and in patients with multiple tumours associated with hereditary non-polyposis colorectal cancer[J]. Gut, 2006, 55(12):1781-1788.
[19]
Umar A, Boland CR, Terdiman JP, et al. Revised Bethesda Guidelines for hereditary nonpolyposis colorectal cancer(Lynch syndrome) and microsatellite instability[J]. J Natl Cancer Inst, 2004, 96(4):261-268.
[20]
Jenkins MA, Hayashi S, O′Shea AM, et al. Pathology Features in Bethesda Guidelines Predict Colorectal Cancer Microsatellite Instability: A Population-Based Study[J]. Gastroenterology, 2007, 133(1):48-56.
[21]
Guastadisegni C, Colafranceschi M, Ottini L, et al. Microsatellite instability as a marker of prognosis and response to therapy: a meta-analysis of colorectal cancer survival data[J]. Eur J Cancer, 2010, 46(15):2788-2798.
[22]
Le DT, Uram JN, Wang H, et al. PD-1 Blockade in Tumors with Mismatch-Repair Deficiency[J]. N Engl J Med, 2015, 372(26):2509-2520.
[23]
Hamilton SR, Bosman FT, Boffetta P, et al. In: Carneiro F, Hruban RH, et al, eds. World Health Organization Tumours. WHO Classification of Tumours of the Digestive System[M]. Lyon: IARC Press, 2010: 134-177.
[24]
Ueno H, Kajiwara Y, Shimazaki HS, et al. New criteria for histologic grading of colorectal cancer[J]. Am J Surg Pathol, 2012, 36(2):193-201.
[25]
Barresi V, Reggiani Bonetti L, Branca G, et al. Colorectal carcinoma grading by quantifying poorly differentiated cell clusters is more reproducible and provides more robust prognostic information than conventional grading[J]. Virchows Arch, 2012, 461(6):621-628.
[26]
Rosty C, Williamson EJ, Clendenning M, et al. Should the grading of colorectal adenocarcinoma include microsatellite instability status?[J]. Hum Pathol, 2014, 45(10):2077-2084.
[27]
Barresi V, Bonetti LR. Correlation between microsatellite instability status and grading assessed by the counting of poorly differentiated clusters in colorectal cancer[J]. Hum Pathol, 2015, 46(7):1063.
[28]
Alcantara SB, Reed W, Willis K, et al. Radiologist participation in multi-disciplinary teams in breast cancer improves reflective practice, decision making and isolation[J]. Eur J Cancer Care(Engl), 2014, 23(5):616-623.
[29]
Zeppernick F, Meinhold-Heerlein I. The new FIGO staging system for ovarian, fallopian tube, and primary peritoneal cancer[J]. Arch Gynecol Obstet, 2014, 290(5):839-842.
[30]
McCluggage WG, Judge MJ, Clarke BA, et al. Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting(ICCR) [J]. Mod Pathol, 2015, 28(8):1101-1122.
[31]
Moss EL, Evans T, Pearmain P, et al. Should All Cases of High-Grade Serous Ovarian, Tubal, and Primary Peritoneal Carcinomas Be Reclassified as Tubo-Ovarian Serous Carcinoma[J]? Int J Gynecol Cancer, 2015, 25(7):1201-1207.
[32]
Nik NN, Vang R, Shih IeM, et al. Origin and pathogenesis of pelvic(ovarian, tubal, and primary peritoneal) serous carcinoma[J]. Annu Rev Pathol, 2014, 9:27-45.
[33]
Herzog TJ, Monk BJ, Rose PG, et al. A phase II trial of oxaliplatin, docetaxel, and bevacizumab as first-line therapy of advanced cancer of the ovary, peritoneum and fallopian tube[J]. Gynecol Oncol, 2014, 132(3):517-525.
[1] 康夏, 田浩, 钱进, 高源, 缪洪明, 齐晓伟. 骨织素抑制破骨细胞分化改善肿瘤骨转移中骨溶解的机制研究[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 329-339.
[2] 代莉, 邓恢伟, 郭华静, 黄芙蓉. 术中持续输注艾司氯胺酮对腹腔镜结直肠癌手术患者术后睡眠质量的影响[J]. 中华普通外科学文献(电子版), 2023, 17(06): 408-412.
[3] 王得晨, 杨康, 杨自杰, 归明彬, 屈莲平, 张小凤, 高峰. 结直肠癌微卫星稳定状态和程序性死亡、吲哚胺2,3-双加氧酶关系的研究进展[J]. 中华普通外科学文献(电子版), 2023, 17(06): 462-465.
[4] 付佳, 肖海敏, 武曦, 冯涛, 师帅. 年龄校正查尔森合并症指数对腹腔镜结直肠癌围手术期并发症的预测价值[J]. 中华普通外科学文献(电子版), 2023, 17(05): 336-341.
[5] 薛永婷, 高峰, 王雅楠, 屈莲平. 溶瘤病毒治疗在结直肠癌中的应用[J]. 中华普通外科学文献(电子版), 2023, 17(05): 380-384.
[6] 武慧铭, 郭仁凯, 李辉宇. 机器人辅助下经自然腔道取标本手术治疗结直肠癌安全性和有效性的Meta分析[J]. 中华普通外科学文献(电子版), 2023, 17(05): 395-400.
[7] 唐旭, 韩冰, 刘威, 陈茹星. 结直肠癌根治术后隐匿性肝转移危险因素分析及预测模型构建[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 16-20.
[8] 张生军, 赵阿静, 李守博, 郝祥宏, 刘敏丽. 高糖通过HGF/c-met通路促进结直肠癌侵袭和迁移的实验研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 21-24.
[9] 李婷, 张琳. 血清脂肪酸代谢物及维生素D水平与结直肠癌发生的关系研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 661-665.
[10] 常剑, 邱峰, 毛郁琪. 摄食抑制因子-1与腹腔镜结直肠癌根治术后肝转移的关系分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 502-505.
[11] 关旭, 王锡山. 基于外科与免疫视角思考结直肠癌区域淋巴结处理的功与过[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 448-452.
[12] 顾睿祈, 方洪生, 蔡国响. 循环肿瘤DNA检测在结直肠癌诊治中的应用与进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 453-459.
[13] 倪文凯, 齐翀, 许小丹, 周燮程, 殷庆章, 蔡元坤. 结直肠癌患者术后发生延迟性肠麻痹的影响因素分析[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 484-489.
[14] 范小彧, 孙司正, 鄂一民, 喻春钊. 梗阻性左半结肠癌不同手术治疗方案的选择应用[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 500-504.
[15] 孙昕, 程海波, 沈卫星. 基于全转录组学探讨仙连解毒方治疗Ⅲ期结直肠癌患者的疗效机制[J]. 中华消化病与影像杂志(电子版), 2023, 13(05): 277-283.
阅读次数
全文


摘要