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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
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dc.contributor.advisor | 吳明賢(Shiang-Ming Wu),邱瀚模(Han-Mo Chiu) | |
dc.contributor.author | Yi-Hsuan Chou | en |
dc.contributor.author | 周邑宣 | zh_TW |
dc.date.accessioned | 2021-06-17T04:28:17Z | - |
dc.date.available | 2021-09-04 | |
dc.date.copyright | 2018-09-04 | |
dc.date.issued | 2018 | |
dc.date.submitted | 2018-08-13 | |
dc.identifier.citation | 1.Booth, C. M., S. Nanji, X. Wei, et al.“Adjuvant Chemotherapy for Stage II Colon Cancer: Practice Patterns and Effectiveness in the General Population.” Clinical Oncology (Royal College of Radiologists (Great Britain)) 29, no. 1 (January 2017): e29–38.
2.Bosman, F.T., Carneiro, F., Hruban et al. “WHO Classification of Tumours of the Digestive System. Fourth Edition - WHO - OMS -.” Accessed April 4, 2018. 3.Catalano, V., F. Loupakis , et al. “Prognosis of Mucinous Histology for Patients with Radically Resected Stage II and III Colon Cancer.” Annals of Oncology: Official Journal of the European Society for Medical Oncology 23, no. 1 (January 2012): 135– 41. 4.Chew, Min-Hoe, Shen-Ann Eugene Yeo et al.“Critical Analysis of Mucin and Signet Ring Cell as Prognostic Factors in an Asian Population of 2,764 Sporadic Colorectal Cancers.” International Journal of Colorectal Disease 25, no. 10 (October 2010): 1221– 29. 5.Chiu, Han-Mo, Sam Li-Sheng Chen, Amy Ming-Fang Yen, et al. “Effectiveness of Fecal Immunochemical Testing in Reducing Colorectal Cancer Mortality from the One Million Taiwanese Screening Program.” Cancer 121, no. 18 (September 15, 2015): 3221–29. 6.Dotan, Efrat, and Steven J. Cohen. “Challenges in the Management of Stage II Colon Cancer.” Seminars in Oncology 38, no. 4 (August 2011): 511–20. 7.Hogan, J., J. P. Burke, G. Samaha et al. “Overall Survival Is Improved in Mucinous Adenocarcinoma of the Colon.” International Journal of Colorectal Disease 29, no. 5 (May 2014): 563–69. 8.Hosseini, Sare, Ali Mohammad Bananzadeh et al.“Prognostic Significance of Mucinous Histologic Subtype on Oncologic Outcomes in Patients With Colorectal Cancer.” Annals of Coloproctology 33, no. 2 (April 2017): 57–63. 9.Hugen, Niek, Gina Brown, Robert Glynne-Jones et al. “Advances in the Care of Patients with Mucinous Colorectal Cancer.” Nature Reviews Clinical Oncology 13, no. 6 (June 2016): 361–69. 10.Hugen, Niek, Cornelis J. van de Velde, et al. “Modern Treatment of Rectal Cancer Closes the Gap Between Common Adenocarcinoma and Mucinous Carcinoma.” Annals of Surgical Oncology 22, no. 8 (August 2015): 2669–76. 11.Ishihara, Soichiro, Toshiaki Watanabe, et al. “Tumor Location Is a Prognostic Factor in Poorly Differentiated Adenocarcinoma, Mucinous Adenocarcinoma, and Signet-Ring Cell Carcinoma of the Colon.” International Journal of Colorectal Disease 27, no. 3 (March 1, 2012): 371–79. 12.Kang, Sung Il, Duck-Woo Kim, et al. “The Prognostic Implications of Primary Tumor Location on Recurrence in Early-Stage Colorectal Cancer with No Associated Risk Factors.” International Journal of Colorectal Disease, March 28, 2018. 13.Labianca, R., B. Nordlinger, G. D. Beretta, et al and ESMO Guidelines Working Group. “Early Colon Cancer: ESMO Clinical Practice Guidelines for Diagnosis,Treatment and Follow-Up.” Annals of Oncology: Official Journal of the European Society for Medical Oncology 24 Suppl 6 (October 2013): vi64-72. 14.Langner, Cord, Lars Harbaum, et al. “Mucinous Differentiation in Colorectal Cancer--Indicator of Poor Prognosis?” Histopathology 60, no. 7 (June 2012): 1060–72. 15.Lee, D.-W., S.-W. Han, et al. “Prognostic Implication of Mucinous Histology in Colorectal Cancer Patients Treated with Adjuvant FOLFOX Chemotherapy.” British Journal of Cancer 108, no. 10 (May 28, 2013): 1978–84. 16.Mekenkamp, Leonie J.M., Karin J. Heesterbeek, et al. “Mucinous Adenocarcinomas: Poor Prognosis in Metastatic Colorectal Cancer.” European Journal of Cancer 48, no. 4 (March 2012): 501–9. 17.Nitsche, Ulrich, Helmut Friess, et al. “Prognosis of Mucinous and Signet-Ring Cell Colorectal Cancer in a Population-Based Cohort.” Journal of Cancer Research and Clinical Oncology 142, no. 11 (November 2016): 2357–66. 18.Nitsche, Ulrich, Anina Zimmermann, et al. “Mucinous and Signet-Ring Cell Colorectal Cancers Differ from Classical Adenocarcinomas in Tumor Biology and Prognosis.” Annals of Surgery 258, no. 5 (November 2013): 775–82; discussion 782- 783. 19.Park, Jong Seob, Jung Wook Huh, Yoon Ah Park, et al. “Prognostic Comparison between Mucinous and Nonmucinous Adenocarcinoma in Colorectal Cancer.” Medicine 94, no. 15 (April 2015): e658. 20.QUASAR Collaborative Group. “Adjuvant Chemotherapy versus Observation in Patients with Colorectal Cancer: A Randomised Study.” The Lancet 370, no. 9604 (December 2007): 2020–29. 21.Sargent, Daniel J., Smitha Patiyil, et al. “End Points for Colon Cancer Adjuvant Trials: Observations and Recommendations Based on Individual Patient Data From 20,898 Patients Enrolled Onto 18 Randomized Trials From the ACCENT Group.” Journal of Clinical Oncology 25, no. 29 (October 10, 2007): 4569– 74. 22.Shia, Jinru, Martine Mcmanus, et al. “Significance of Acellular Mucin Pools in Rectal Carcinoma After Neoadjuvant Chemoradiotherapy.” The American Journal of Surgical Pathology 35, no. 1 (January 1, 2011): 127–34. 23.Teixeira, L., T. Hickish, C. Tournigand et al. “Efficacy of FOLFOX4 as Adjuvant Therapy in Stage II Colon Cancer (CC): A New Analysis of the MOSAIC Trial According to Risk Factors.” Journal of Clinical Oncology 28, no. 15_suppl (May 20, 2010): 3524–3524. 24.Tsikitis, Vassiliki L, David W Larson, et al. “Predictors of Recurrence Free Survival for Patients with Stage II and III Colon Cancer.” BMC Cancer 14 (May 16, 2014): 336. 25.Verhulst, J., L. Ferdinande, P. Demetter, et al.“Mucinous Subtype as Prognostic Factor in Colorectal Cancer: A Systematic Review and Meta-Analysis.” Journal of Clinical Pathology 65, no. 5 (May 2012): 381–88. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/70442 | - |
dc.description.abstract | 前言:
大腸癌的發生率及盛行率日益提高。隨著糞便篩檢普及,更多早期癌能提早被診斷,而其治療及追蹤方式更是臨床重要課題。目前建議針對術後診斷為第三期 (淋巴轉移)的大腸癌需做化學治療;而目前化療對第二期大腸癌幫助仍有爭議。專 家會議仍強烈建議高危險性第二期大腸癌(手術淋巴檢體數目小於 12 個;手術前腫 瘤已經破裂;組織為腫瘤分化不良型;侵犯深度為 T4;腫瘤有淋巴血管侵犯或神經侵 犯)病人接受化療。然而化學治療對含有黏液蛋白(mucin)組織的第二期大腸癌(無淋巴轉移)存活是否有幫助仍有爭議:大多數國外期刊論文並不認為黏液蛋白是第二期大腸癌預後的危險因子,但許多研究發現黏液蛋白其生物特性對化學治療有 抗藥性或對末期大腸癌有不良預後。而我們在臨床上觀察也發現帶有黏液蛋白組 織的第二期病人比起沒有黏液蛋白的病人有較差的存活率。 方法: 我們設計了一單中心回溯性研究,回顧台大醫院十年來(2005~2014)術後診斷為 第二期大腸癌1031位病人病理組織是否帶有黏液蛋白的存活(overall survival)及無疾病復發預後 (disease free survival)是否不同。我們將組織病理細分成高惡性度 (high-grade),黏液型(mucinous),腺癌帶有黏液(AIM: mucin<50%)及非黏液型 (low grade)。 結果: 我們的研究發現第二期黏液型大腸癌(mucinous)比非黏液型(low- grade)第二期大腸癌有較差disease free survival (P=0.04, HR:1.71, 95% CI:1.02-2.88); 但overall survival(P=0.15, HR:1.45, 95% CI: 0.87-2.43)並無顯著差別。經多變相分 析包含考慮年齡、性別、腫瘤深度(T3 or T4)、腫瘤位置(直腸或非直腸)、是否有淋巴血管侵犯或神經侵犯與病人是否接受化學治療等因素發現黏液型大腸癌仍在 disease free survival顯現較差的預後(HR:1.78, 95%CI:1.03-3.10)。 結論: 在此回溯性研究中,黏液型大腸癌比起非黏液型大腸癌在 disease free survival 有較差的預後。因此可做為高風險因子及術後追加化學治療的參考指標;而化學治療對於第二期大腸癌的預後影響,仍需前瞻性研究佐證。 | zh_TW |
dc.description.abstract | Background and aim: The incidence of colorectal cancer(CRC) was rising worldwide. Because the implementation of FIT screening, more and more early-staged CRCs were diagnosed. Therefore, it became an important issue how to manage these early-staged CRC, including stage II CRC. Stage II CRC with high risk features was known beneficial from adjuvant chemotherapy. High risk features included inadequate lymph node retrieval(N<12), tumor perforation before surgery, poorly differentiated histology, T4 tumor, lymphovascular or perineural invasion. However, whether the adjuvant chemotherapy was needed for stage II CRC with mucinous histology remained unknown. Therefore, this study aimed to investigate the difference in disease-free survival (DFS)and overall survival(OS) between stage II CRC with and without mucinous
histology. Methods: This was a retrospective study and the subjects were enrolled from the list of NTUH cancer registry during 2005 to 2014. A total of 1031 radically resected stage II patients were enrolled. Each case was divided into one of the four groups by histology, including low-grade, high-grade, mucinous and adenocarcinoma with intermediate mucin (AIM) respectively. The recurrence and mortality was checked by chart review. Theprimary endpoint of our study were disease free survival and overall survival. The survival outcomes between different groups were compared with Log-rank test and cox- regression analysis. Results: The median follow-up period was 50.7 months in the study. The DFS was significantly worse in mucinous in comparison with low-grade counterpart(HR=1.71, 95% CI:1.02-2.88). OS was not significantly different between two groups (HR:1.45, 95% CI: 0.87-2.43). Mucinous histology was an independent risk factor of recurrence (HR:1.78, 95%CI:1.03-3.10) after adjusted by multivariate analysis. Conclusion: Mucinous histology had worse disease-free survival compared with low- grade adenocarcinoma in this retrospective study. Whether chemotherapy is beneficial for this specific group of patient needs further prospective study. | en |
dc.description.provenance | Made available in DSpace on 2021-06-17T04:28:17Z (GMT). No. of bitstreams: 1 ntu-107-P05421019-1.pdf: 1129257 bytes, checksum: 73dfee95f092fde547f3cb55553bdb8e (MD5) Previous issue date: 2018 | en |
dc.description.tableofcontents | 目錄
口試委員會審定書.......................................................................... i 誌謝............................................................................................... ii 中文摘要....................................................................................... iii 英文摘要........................................................................................ v 碩士論文內容 Introduction .....................................................................................1 Methods.......................................................................................... 5 Results.............................................................................................8 Discussion..................................................................................... 11 Limitation and conclusion ..............................................................17 Reference ......................................................................................18 Figure 1 and Figure 1-1..................................................................22 Figure 2......................................................................................... 23 Figure 3..........................................................................................24 Figure 4..........................................................................................25 Table 1........................................................................................... 26 Table 2........................................................................................... 27 Table 3............................................................................................28 Supplement table ....................................................................29 -31 | |
dc.language.iso | en | |
dc.title | 針對第二期大腸癌是否含有黏液蛋白組織之長期預後比較 | zh_TW |
dc.title | Comparison of long term outcome between radically resected stage II colorectal cancer with or without mucin histology | en |
dc.type | Thesis | |
dc.date.schoolyear | 106-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 楊宏志(Hung-Chih Yang) | |
dc.subject.keyword | 第二期大腸癌,黏液蛋白,癌症復發率,癌症存活率,化學治療, | zh_TW |
dc.subject.keyword | stage II CRC,mucin histology,disease free survival, overall survival,chemotherapy, | en |
dc.relation.page | 31 | |
dc.identifier.doi | 10.6342/NTU201802520 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2018-08-14 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床醫學研究所 | zh_TW |
顯示於系所單位: | 臨床醫學研究所 |
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