Tsujinaka T, Shiozaki H, Yano M, Kikkawa N, Takami M, Monden M
Osaka Gastric Cancer Study Group and Department of Surgery II, Osaka University Medical School, Osaka, Japan.
Oncol Rep. 2001 Jan-Feb;8(1):33-8. doi: 10.3892/or.8.1.33.
Prognostic value of clinicopathologic factors and biologic markers was analyzed in 185 patients who received a curative resection and adjuvant chemotherapy of pathologically confirmed stage II or III gastric cancer. No difference was found between the chemotherapeutic regimens according to the frequency of recurrence, but tumor type, histology, depth of invasion, nodal metastasis, and lymphatic and venous invasion were significantly different between recurrent (n=62) and non-recurrent (n=123) patients. However, the degree of lymphatic dissection and the patterns of biological markers (DNA ploidy, p53 staining and PCNA labeling) were not different. Hepatic metastasis and venous invasion were more frequent on patients recurring within one year, compared to those who recurred later. Multivariate analyses showed that depth of invasion, level 2 lymph node metastasis and tumor histology were risk factors for recurrence. Pathologic factors were more important for predicting recurrence than biological markers.
对185例接受了根治性切除及辅助化疗的病理确诊为II期或III期胃癌患者的临床病理因素和生物学标志物的预后价值进行了分析。根据复发频率,化疗方案之间未发现差异,但复发患者(n = 62)和未复发患者(n = 123)之间的肿瘤类型、组织学、浸润深度、淋巴结转移以及淋巴管和静脉侵犯存在显著差异。然而,淋巴清扫程度和生物学标志物模式(DNA倍体、p53染色和PCNA标记)并无差异。与复发较晚的患者相比,一年内复发的患者肝转移和静脉侵犯更为常见。多因素分析显示,浸润深度、2级淋巴结转移和肿瘤组织学是复发的危险因素。病理因素在预测复发方面比生物学标志物更为重要。