Kunisaki C, Shimada H, Takahashi M, Ookubo K, Moriwaki Y, Akiyama H, Nomura M
Second Department of Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
Hepatogastroenterology. 2001 Jan-Feb;48(37):294-8.
BACKGROUND/AIMS: Opportunities of observing patients with recurrent early gastric cancer are rare. Assessment of prognostic factors for the recurrence of early gastric cancer is important for determining adequate strategies for managing early gastric cancer.
Clinicopathologic variables were compared in 8 patients with and 453 without recurrence who were followed for over 5 years after curative resection. Expression of mutant p53 and Ki-67 was evaluated in 16 patients with n2 or above.
Eight patients died of gastric cancer with recurrence. There were no inter-group differences in mean diameter, histologic classification, patterns of infiltrating growth, or cancer-stroma relationship; but macroscopic appearance, depth of invasion, lymphatic invasion, venous invasion and lymph node metastases were significantly more frequent on univariate analysis in those with recurrence. Lymph node metastases was an independent prognostic factor by the Cox proportional hazards regression model. In patients with n2 or above, mutant p53 expression was higher in recurrent than in nonrecurrent cases.
Lymph node metastasis was the only independent prognostic factor for the recurrence of early gastric cancer. The expression of mutant p53 may be an indicator of recurrence in patients with n2 or above.
背景/目的：观察复发性早期胃癌患者的机会很少。评估早期胃癌复发的预后因素对于确定早期胃癌的适当管理策略很重要。
对8例复发患者和453例未复发患者进行了临床病理变量比较，这些患者在根治性切除术后随访超过5年。对16例n2及以上患者评估了突变型p53和Ki-67的表达。
8例患者死于复发性胃癌。平均直径、组织学分类、浸润性生长模式或癌间质关系在组间无差异；但在单因素分析中，复发患者的肉眼外观、浸润深度、淋巴血管侵犯和淋巴结转移明显更常见。通过Cox比例风险回归模型，淋巴结转移是独立的预后因素。在n2及以上患者中，复发患者的突变型p53表达高于未复发患者。
淋巴结转移是早期胃癌复发的唯一独立预后因素。突变型p53的表达可能是n2及以上患者复发的一个指标。
