大肠侧向发育型肿瘤的研究进展

doi:10.3969/j.issn.2095-378X.2022.02.013

摘要/Abstract

摘要： 大肠侧向发育型肿瘤（laterally spreading tumors, LSTs）是一类发生于结直肠,较大且相对平坦,沿着肠壁呈侧向生长的非息肉样病变,由于其独特的形态学特征,受到学者们的广泛关注与重视,现对近年来LSTs在临床特征、分子生物学以及内镜诊治方面的研究进展作一综述。

关键词: 侧向发育型肿瘤, 临床特征, 分子生物学, 内镜诊治

Abstract: Laterally spreading tumors （LSTs） are nonpolypoid lesions occurring in colorectum, large, relatively flat, and growing laterally along the intestinal wall. Due to their unique morphology, LSTs have attracted much attention from scholars. This article reviewed the research progress on clinicopathological characteristics, molecular biological features, and endoscopic diagnosis and treatment of LSTs.

Key words: Laterally spreading tumors, Clinicopathological characteristics, Molecular biology, Endoscopic diagnosis and treatment

中图分类号:

R735.34

孙可靖, 许树长. 大肠侧向发育型肿瘤的研究进展[J]. 外科研究与新技术, 2022, 11(2): 126-132.

SUN Kejing, XU Shuchang. Research progress of laterally spreading tumors in colorectum[J]. Surgical Research and New Technique, 2022, 11(2): 126-132.

参考文献

[1] Kudo S.Endoscopic mucosal resection of flat and depressed types of early colorectal cancer[J]. Endoscopy, 1993, 25(7): 455-461.
[2] Kudo SE, Lambert R, Allen JI, et al.Nonpolypoid neoplastic lesions of the colorectal mucosa[J]. Gastrointest Endosc, 2008, 68(Suppl 4): S3-S47.
[3] Kudo SE, Takemura O, Ohtsuka K.Flat and depressed types of early colorectal cancers: from east to west[J]. Gastrointest Endosc Clin N Am, 2008, 18(3): 581-593.
[4] Kobayashi K, Tanaka S, Murakami Y, et al.Predictors of invasive cancer of large laterally spreading colorectal tumors: a multicenter study in Japan[J]. JGH Open, 2020, 4(1): 83-89.
[5] Participants in the Paris Workshop. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002[J]. Gastrointest Endosc, 2003, 58(Suppl 6): S3-S43.
[6] Lambert R, Tanaka S.Laterally spreading tumors in the colon and rectum[J]. Eur J Gastroenterol Hepatol, 2012, 24(10): 1123-1134.
[7] Saito Y, Fujii T, Kondo H, et al.Endoscopic treatment for laterally spreading tumors in the colon[J]. Endoscopy, 2001, 33(8): 682-686.
[8] Bogie RMM, Veldman MHJ, Snijders LARS, et al.Endoscopic subtypes of colorectal laterally spreading tumors (LSTs) and the risk of submucosal invasion: a meta-analysis[J]. Endoscopy, 2018, 50(3): 263-282.
[9] Nishiyama H, Isomoto H, Yamaguchi N, et al.Endoscopic submucosal dissection for laterally spreading tumours of the colorectum in 200 consecutive cases[J]. Surg Endosc, 2010, 24(11): 2881-2887.
[10] Uraoka T, Saito Y, Matsuda T, et al.Endoscopic indications for endoscopic mucosal resection of laterally spreading tumours in the colorectum[J]. Gut, 2006, 55(11): 1592-1597.
[11] Kim KO, Jang BI, Jang WJ, et al.Laterally spreading tumors of the colorectum: clinicopathologic features and malignant potential by macroscopic morphology[J]. Int J Colorectal Dis, 2013, 28(12): 1661-1666.
[12] Miyamoto H, Ikematsu H, Fujii S, et al.Clinicopathological differences of laterally spreading tumors arising in the colon and rectum[J]. Int J Colorectal Dis, 2014, 29(9): 1069-1075.
[13] Saito Y, Yamada M, So E, et al.Colorectal endoscopic submucosal dissection: technical advantages compared to endoscopic mucosal resection and minimally invasive surgery[J]. Dig Endosc, 2014, 26(Suppl 1): 52-61.
[14] Vogelstein B, Fearon ER, Hamilton SR, et al.Genetic alterations during colorectal-tumor development[J]. N Engl J Med, 1988, 319(9): 525-532.
[15] Jass JR, Whitehall VLJ, Young J, et al.Emerging concepts in colorectal neoplasia[J]. Gastroenterology, 2002, 123(3): 862-876.
[16] Mukawa K, Fujii S, Takeda J, et al.Analysis of K-ras mutations and expression of cyclooxygenase-2 and gastrin protein in laterally spreading tumors[J]. J Gastroenterol Hepatol, 2005, 20(10): 1584-1590.
[17] Sugimoto T, Ohta M, Ikenoue T, et al.Macroscopic morphologic subtypes of laterally spreading colorectal tumors showing distinct molecular alterations[J]. Int J Cancer, 2010, 127(7): 1562-1569.
[18] Hiraoka S, Kato J, Tatsukawa M, et al.Laterally spreading type of colorectal adenoma exhibits a unique methylation phenotype and K-ras mutations[J]. Gastroenterology, 2006, 131(2): 379-389.
[19] Kim BC, Chang HJ, Su Han K, et al.Clinicopathological differences of laterally spreading tumors of the colorectum according to gross appearance[J]. Endoscopy, 2011, 43(2): 100-107.
[20] Kessler D, Gmachl M, Mantoulidis A, et al.Drugging an undruggable pocket on KRAS[J]. Proc Natl Acad Sci U S A, 2019, 116(32): 15823-15829.
[21] Sakai E, Fukuyo M, Matsusaka K, et al.TP53 mutation at early stage of colorectal cancer progression from two types of laterally spreading tumors[J]. Cancer Sci, 2016, 107(6): 820-827.
[22] Nakae K, Mitomi H, Saito T, et al.MUC5AC/β-catenin expression and KRAS gene alteration in laterally spreading colorectal tumors[J]. World J Gastroenterol, 2012, 18(39): 5551-5559.
[23] Wiman KG.Pharmacological reactivation of mutant p53: from protein structure to the cancer patient[J]. Oncogene, 2010, 29(30): 4245-4252.
[24] Yue X, Zhao Y, Xu Y, et al.Mutant p53 in cancer: accumulation, gain-of-function, and therapy[J]. J Mol Biol, 2017, 429(11): 1595-1606.
[25] Nagai K, Hayashi Y, Honma K, et al.Adenoma of colorectal laterally spreading tumor nongranular type with biological phenotypic features similar to cancer[J]. J Gastroenterol Hepatol, 2018, 33(11): 1853-1863.
[26] Sugai T, Habano W, Takagi R, et al.Analysis of molecular alterations in laterally spreading tumors of the colorectum[J]. J Gastroenterol, 2017, 52(6): 715-723.
[27] Hayashi H, Beppu T, Sakamoto Y, et al.Prognostic value of Ki-67 expression in conversion therapy for colorectal liver-limited metastases[J]. Am J Cancer Res, 2015, 5(3): 1225-1233.
[28] Noro A, Sugai T, Habano W, et al.Analysis of Ki-ras and p53 gene mutations in laterally spreading tumors of the colorectum[J]. Pathol Int, 2003, 53(12): 828-836.
[29] Tanaka S, Kashida H, Saito Y, et al.Japan Gastroenterological Endoscopy Society guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection[J]. Dig Endosc, 2020, 32(2): 219-239.
[30] Pimentel-Nunes P, Libânio D, Bastiaansen BAJ, et al.Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) guideline update 2022[J]. Endoscopy, 2022, 54(6): 591-622.
[31] Yamada M, Saito Y, Sakamoto T, et al.Endoscopic predictors of deep submucosal invasion in colorectal laterally spreading tumors[J]. Endoscopy, 2016, 48(5): 456-464.
[32] Sakamoto T, Nakajima T, Matsuda T, et al.Comparison of the diagnostic performance between magnifying chromoendoscopy and magnifying narrow-band imaging for superficial colorectal neoplasms: an online survey[J]. Gastrointest Endosc, 2018, 87(5): 1318-1323.
[33] Hayashi N, Tanaka S, Hewett DG, et al.Endoscopic prediction of deep submucosal invasive carcinoma: validation of the narrow-band imaging international colorectal endoscopic (NICE) classification[J]. Gastrointest Endosc, 2013, 78(4): 625-632.
[34] Sumimoto K, Tanaka S, Shigita K, et al.Clinical impact and characteristics of the narrow-band imaging magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team[J]. Gastrointest Endosc, 2017, 85(4): 816-821.
[35] Iwatate M, Sano Y, Tanaka S, et al.Validation study for development of the Japan NBI Expert Team classification of colorectal lesions[J]. Dig Endosc, 2018, 30(5): 642-651.
[36] Vosko S, Shahidi N, Sidhu M, et al. Optical evaluation for predicting cancer in large nonpedunculated colorectal polyps is accurate for flat lesions[J]. Clin Gastroenterol Hepatol, 2021, 19(11): 2425-2434.e4.
[37] Burgess NG, Hourigan LF, Zanati SA, et al. Risk stratification for covert invasive cancer among patients referred for colonic endoscopic mucosal resection: a large multicenter cohort[J]. Gastroenterology, 2017, 153(3): 732-742.e1.
[38] Oka S, Tanaka S, Kanao H, et al.Therapeutic strategy for colorectal laterally spreading tumor[J]. Dig Endosc, 2009, 21(Suppl 1): S43-S46.
[39] Yamada T, Shimura T, Ebi M, et al.Subset analysis of a multicenter, randomized controlled trial to compare magnifying chromoendoscopy with endoscopic ultrasonography for stage diagnosis of early stage colorectal cancer[J]. PLoS One, 2015, 10(8): e0134942.
[40] Santoro GA, Gizzi G, Pellegrini L, et al.The value of high-resolution three-dimensional endorectal ultrasonography in the management of submucosal invasive rectal tumors[J]. Dis Colon Rectum, 2009, 52(11): 1837-1843.
[41] Li Y, Zhang Y, Chen Y, et al.Long-term outcomes of endoscopic treatment for colorectal laterally spreading tumor: a large-scale multicenter retrospective study from China[J]. Surg Endosc, 2021, 35(2): 736-744.
[42] Chan BPH, Patel R, Mbuagbaw L, et al. EUS versus magnetic resonance imaging in staging rectal adenocarcinoma: a diagnostic test accuracy meta-analysis[J]. Gastrointest Endosc, 2019, 90(2): 196-203.e1.
[43] Gao Y, Li J, Ma X, et al.The value of four imaging modalities in diagnosing lymph node involvement in rectal cancer: an overview and adjusted indirect comparison[J]. Clin Exp Med, 2019, 19(2): 225-234.
[44] Li XT, Zhang XY, Sun YS, et al.Evaluating rectal tumor staging with magnetic resonance imaging, computed tomography, and endoluminal ultrasound: a meta-analysis[J]. Medicine, 2016, 95(44): e5333.
[45] Li XT, Sun YS, Tang L, et al.Evaluating local lymph node metastasis with magnetic resonance imaging, endoluminal ultrasound and computed tomography in rectal cancer: a meta-analysis[J]. Colorectal Dis, 2015, 17(6): O129-O135.
[46] Hashiguchi Y, Muro K, Saito Y, et al.Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer[J]. Int J Clin Oncol, 2020, 25(1): 1-42.
[47] Yamashita K, Oka S, Tanaka S, et al.Preceding endoscopic submucosal dissection for T1 colorectal carcinoma does not affect the prognosis of patients who underwent additional surgery: a large multicenter propensity score-matched analysis[J]. J Gastroenterol, 2019, 54(10): 897-906.
[48] Tanaka S, Oka S, Kaneko I, et al.Endoscopic submucosal dissection for colorectal neoplasia: possibility of standardization[J]. Gastrointest Endosc, 2007, 66(1): 100-107.
[49] Tamegai Y, Saito Y, Masaki N, et al.Endoscopic submucosal dissection: a safe technique for colorectal tumors[J]. Endoscopy, 2007, 39(5): 418-422.
[50] Ferlitsch M, Moss A, Hassan C, et al.Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline[J]. Endoscopy, 2017, 49(3): 270-297.
[51] Lee EY, Bourke MJ.EMR should be the first-line treatment for large laterally spreading colorectal lesions[J]. Gastrointest Endosc, 2016, 84(2): 326-328.
[52] Kobayashi N, Yoshitake N, Hirahara Y, et al.Matched case-control study comparing endoscopic submucosal dissection and endoscopic mucosal resection for colorectal tumors[J]. J Gastroenterol Hepatol, 2012, 27(4): 728-733.
[53] Saito Y, Fukuzawa M, Matsuda T, et al.Clinical outcome of endoscopic submucosal dissection versus endoscopic mucosal resection of large colorectal tumors as determined by curative resection[J]. Surg Endosc, 2010, 24(2): 343-352.
[54] Russo P, Barbeiro S, Awadie H, et al.Management of colorectal laterally spreading tumors: a systematic review and meta-analysis[J]. Endosc Int Open, 2019, 7(2): E239-E259.
[55] Fujiya M, Tanaka K, Dokoshi T, et al.Efficacy and adverse events of EMR and endoscopic submucosal dissection for the treatment of colon neoplasms: a meta-analysis of studies comparing EMR and endoscopic submucosal dissection[J]. Gastrointest Endosc, 2015, 81(3): 583-595.
[56] Arezzo A, Passera R, Marchese N, et al.Systematic review and meta-analysis of endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal lesions[J]. United Eur Gastroenterol J, 2016, 4(1): 18-29.
[57] Kaltenbach T, Anderson JC, Burke CA, et al.Endoscopic removal of colorectal lesions—recommendations by the US Multi-Society Task Force on Colorectal Cancer[J]. Gastroenterology, 2020, 158(4): 1095-1129.
[58] Saito Y, Ono A, García VAJ, et al.Diagnosis and treatment of colorectal tumors: differences between Japan and the West and future prospects[J]. Den Open, 2022, 2(1): e66.
[59] Fujishiro M, Yahagi N, Kakushima N, et al.Outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms in 200 consecutive cases[J]. Clin Gastroenterol Hepatol, 2007, 5(6): 678-683.
[60] Tanaka S, Oka S, Chayama K.Colorectal endoscopic submucosal dissection: present status and future perspective, including its differentiation from endoscopic mucosal resection[J]. J Gastroenterol, 2008, 43(9): 641-651.
[61] Oka S, Tanaka S, Saito Y, et al.Local recurrence after endoscopic resection for large colorectal neoplasia: a multicenter prospective study in Japan[J]. Am J Gastroenterol, 2015, 110(5): 697-707.
[62] Belderbos TDG, Leenders M, Moons LMG, et al.Local recurrence after endoscopic mucosal resection of nonpedunculated colorectal lesions: systematic review and meta-analysis[J]. Endoscopy, 2014, 46(5): 388-402.
[63] Hotta K, Saito Y, Matsuda T, et al.Local recurrence and surveillance after endoscopic resection of large colorectal tumors[J]. Dig Endosc, 2010, 22(Suppl 1): S63-S68.
[64] Klein A, Tate DJ, Jayasekeran V, et al. Thermal ablation of mucosal defect margins reduces adenoma recurrence after colonic endoscopic mucosal resection[J]. Gastroenterology, 2019, 156(3): 604-613.e3.
[65] Sidhu M, Shahidi N, Gupta S, et al. Outcomes of thermal ablation of the mucosal defect margin after endoscopic mucosal resection: a prospective, international, multicenter trial of1000 large nonpedunculated colorectal polyps[J]. Gastroenterology, 2021, 161(1): 163-170.e3.
[66] Moss A, Bourke MJ, Williams SJ, et al.Endoscopic mucosal resection outcomes and prediction of submucosal cancer from advanced colonic mucosal neoplasia[J]. Gastroenterology, 2011, 140(7): 1909-1918.
[67] Hahn KY, Park JC, Kim EH, et al. Incidence and impact of scheduled endoscopic surveillance on recurrence after curative endoscopic resection for early gastric cancer[J]. Gastrointest Endosc, 2016, 84(4): 628-638.e1.
[68] Yamashita K, Oka S, Tanaka S, et al.Long-term prognosis after treatment for T1 carcinoma of laterally spreading tumors: a multicenter retrospective study[J]. Int J Colorectal Dis, 2019, 34(3): 481-490.
[69] Cong ZJ, Hu LH, Ji JT, et al.A long-term follow-up study on the prognosis of endoscopic submucosal dissection for colorectal laterally spreading tumors[J]. Gastrointest Endosc, 2016, 83(4): 800-807.