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胃癌根治性胃切除术后的临床病理及免疫组化标志物

Clinicopathological and immunohistochemical markers after radical gastrectomy for gastric cancer.

作者信息

Potrc Stojan, Gadiijev Eldar, Hajdinjak Tine, Kavalar Rajko

机构信息

Department of Abdominal Surgery, Maribor Teaching Hospital, Maribor, Slovenia.

出版信息

Hepatogastroenterology. 2007 Jan-Feb;54(73):308-14.

Abstract

BACKGROUND/AIMS: The aim of the study was to verify the classic clinicopathological prognostic factors of the expected survival, to determine the frequency of immunohistochemical factors (C-erB-2, p53) and to verify these immunohistochemical factors in their function as prognostic factors in gastric cancer patients after a potentially curative gastric resection.

METHODOLOGY

In 78 gastric cancer patients after a potentially curative resection the clinicopathological factors (age, general performance of the patient, tumor diameter, TNM stage, stage according to UICC, type of operation and the extent of lymphadenectomy) and immunohistochemical factors (p53 and C-erB-2) were analyzed.

RESULTS

In univariate analysis ASA stage of general performance, size of tumor, TNM stage and stage according to UICC exert significant influence on the median survival. Median survival is higher in patients with C-erB-2 negative reaction and in those with p53 positive reaction, although not significant. In patients with tumor located in proximal two thirds, patients with negative reaction to C-erB-2 have a significantly higher median survival than patients with positive reaction to C-erB-2. The Cox regression model reveals ASA stage and UICC classification to be significant factors whereas immunohistochemical parameters C-erB-2 and p53 do not reveal any significance in the multivariate survival analysis.

CONCLUSIONS

According to the results of our study the ASA stage and UICC classification influence the expected survival of potentially radically resected gastric cancer patients significantly, while immunohistochemical parameters C-erB-2 and p53 do not.

摘要

背景/目的:本研究旨在验证预期生存的经典临床病理预后因素,确定免疫组化因素(C-erB-2、p53)的频率,并验证这些免疫组化因素在胃癌患者行根治性胃切除术后作为预后因素的作用。

方法

对78例行根治性切除的胃癌患者的临床病理因素(年龄、患者一般状况、肿瘤直径、TNM分期、国际抗癌联盟(UICC)分期、手术类型及淋巴结清扫范围)和免疫组化因素(p53和C-erB-2)进行分析。

结果

单因素分析显示,患者的美国麻醉医师协会(ASA)一般状况分级、肿瘤大小、TNM分期及UICC分期对中位生存期有显著影响。C-erB-2阴性反应患者和p53阳性反应患者的中位生存期较高,尽管差异无统计学意义。肿瘤位于近端三分之二的患者中,C-erB-2阴性反应患者的中位生存期显著高于C-erB-2阳性反应患者。Cox回归模型显示,ASA分级和UICC分类是显著因素,而免疫组化参数C-erB-2和p53在多因素生存分析中无显著意义。

结论

根据我们的研究结果,ASA分级和UICC分类对根治性切除的胃癌患者的预期生存有显著影响,而免疫组化参数C-erB-2和p53则无此影响。

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