Kunisaki Chikara, Akiyama Hirotoshi, Nomura Masato, Matsuda Goro, Otsuka Yuichi, Ono Hidetaka Andrew, Shimada Hiroshi
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
Ann Surg Oncol. 2006 Jun;13(6):836-42. doi: 10.1245/ASO.2006.03.077. Epub 2006 Apr 13.
The clinicopathologic characteristics of mucinous gastric carcinoma (MGC), an uncommon subtype of gastric carcinoma, were examined by comparing 45 MGC and 1255 non-MGC (NGC) cases.
Of 1300 gastric cancer patients, 1184 (early, n=568; advanced, n=616) underwent potentially curative or palliative resection. Age, sex, tumor location, tumor diameter, macroscopic appearance, depth of invasion, lymph node metastasis, lymphatic invasion, and venous invasion were monitored.
In all registered patients, MGC patients' characteristics were as follows: advanced-stage disease (P=.0293), macroscopically ill-defined tumors (P=.0051), deeper invasion (P=.0046), and more lymph node involvement (P=.0008). Although there were no significant differences between curatively resected MGC and NGC advanced-cancer patients, in curatively resected early-cancer patients, depth of invasion (P=.0060) and lymphatic invasion (P=.0374) were significantly different. Survival time in all registered patients was shorter for MGC patients (P=.0489). Survival of curatively resected advanced and early gastric cancer patients was not significantly different. Age, macroscopic appearance, tumor diameter, depth of invasion, lymph node metastasis, and curability, but not histological type, were independent prognostic factors in all registered patients. Histological type also did not influence prognosis after curative resection. MGC patients had significantly more metastatic lymph nodes and lymphatic and venous invasion. Survival was significantly different (P=.0450) between all patients with undifferentiated and differentiated MGC, but not in curatively resected patients.
MGC patients' poor prognosis correlates with advanced disease at diagnosis. Therapeutic and follow-up plans after curative resected MGC and NGC should remain the same, possibly with alterations according to the former's histological subtype.
通过比较45例黏液性胃癌（MGC）和1255例非黏液性胃癌（NGC）病例，研究了这种不常见的胃癌亚型的临床病理特征。
1300例胃癌患者中，1184例（早期，n = 568；晚期，n = 616）接受了根治性或姑息性切除。监测患者的年龄、性别、肿瘤位置、肿瘤直径、大体外观、浸润深度、淋巴结转移、淋巴管浸润和静脉浸润情况。
在所有登记患者中，MGC患者具有以下特征：疾病分期较晚（P = 0.0293）、大体上边界不清的肿瘤（P = 0.0051）、浸润更深（P = 0.0046）以及更多的淋巴结受累（P = 0.0008）。虽然根治性切除的MGC和NGC晚期癌症患者之间没有显著差异，但在根治性切除的早期癌症患者中，浸润深度（P = 0.0060）和淋巴管浸润（P = 0.0374）存在显著差异。所有登记患者中，MGC患者的生存时间较短（P = 0.0489）。根治性切除的晚期和早期胃癌患者的生存率没有显著差异。年龄、大体外观、肿瘤直径、浸润深度、淋巴结转移和可治愈性是所有登记患者的独立预后因素，但组织学类型不是。组织学类型也不影响根治性切除后的预后。MGC患者有更多的转移淋巴结以及淋巴管和静脉浸润。未分化和分化的MGC患者的生存率有显著差异（P = 0.0450），但根治性切除患者无此差异。
MGC患者预后不良与诊断时的晚期疾病相关。根治性切除的MGC和NGC后的治疗及随访计划应保持相同，可能根据前者的组织学亚型进行调整。
