Study on the relationship between the desmoplastic reaction at the tumor infiltration front and the invasion ability and prognosis of colorectal adenocarcinoma

PENG Hui; ZHANG Zhi-fa; WU Ying-jun

doi:10.19538/j.cjps.issn1005-2208.2025.02.14

Abstract：Objective To investigate the relationship between the type of desmoplastic reaction at the tumor invasion front and the invasive ability and prognosis of colorectal adenocarcinoma.Methods A retrospective study was conducted.The clinicopathological data of 155 patients with stage Ⅲ moderately differentiated colorectal adenocarcinoma who underwent radical resection at.Guangdong Provincial Hospital of Traditional Chinese Medicine from January 1,2014,to December 31,2015,were collected.The patients were divided into mature type(34 cases),intermediate type(92 cases),and immature type(29 cases)according to the type of desmoplastic reaction at the tumor invasion front.The clinical data and tumor invasion ability of the three groups were compared.The Kaplan-Meier method was used to compare the differences in survival rates among the three groups.The survival curves were drawn and the differences in overall survival(OS)among the three groups were analyzed using the log-rank test.The Cox proportional hazard regression model was used to analyze the influencing factors for OS after colorectal adenocarcinoma surgery.Results The incidence of T4 in mature,intermediate,and immature types was 8.8％,27.2％,and 34.5％,respectively.There were statistically significant differences in the distribution of T stages,the proportion of vascular invasion,and the proportion of nerve invasion among the three groups(P＜0.05).Among them,compared with the mature type,the T stage distribution,the proportion of immature vascular invasion,and the proportion of intermediate nerve invasion in the intermediate type and the immature type were different,and the difference was statistically significant(P＜0.05).The desmoplastic reaction was positively correlated with T stage(r=0.249,P=0.001),lymphovascular invasion(r=0.200,P=0.009),and neural invasion(r=0.181,P=0.019),but was not related to N stage(r=-0.008,P=0.917).There was a significant difference in the OS of different types of desmoplastic reaction(log-rank x2=6.39,P=0.041),and the 3-year and 5-year OS of patients with mature type are longer than patients with intermediate and immature types(P＜0.05).Age＞60 years(HR=1.94,95％CI 1.02-3.72,P=0.046)was an independent risk factor for OS after colorectal adenocarcinoma surgery,while negative neural invasion(HR=0.41,95％CI 0.23-0.72,P=0.002)and mature or intermediate desmoplastic reaction at the invasive front(HR=0.54,95％CI 0.29-0.99,P=0.048)were independent protective factors for OS after colorectal adenocarcinoma surgery.Conclusion The more immature the desmoplastic reaction at the tumor infiltration front,the stronger the invasive ability and the worse the prognosis.