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胃癌组织学:临床病理特征及预后价值

Gastric cancer histology: clinicopathologic characteristics and prognostic value.

作者信息

Park Joong-Min, Jang You-Jin, Kim Jong-Han, Park Sung-Soo, Park Seong-Heum, Kim Seung-Joo, Mok Young-Jae, Kim Chong-Suk

机构信息

Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

出版信息

J Surg Oncol. 2008 Dec 1;98(7):520-5. doi: 10.1002/jso.21150.

Abstract

BACKGROUND AND OBJECTIVES

Gastric cancer can be divided into two major histologic categories, that is, differentiated and undifferentiated types. In the present study, we sought to clarify the prognoses and clinicopathologic characteristics of signet ring cell carcinoma and mucinous carcinoma, both of which are mucin-producing tumors of the undifferentiated type.

METHODS

We retrospectively reviewed medical records of 2,275 patients who underwent gastric resection. Cases were divided into four histologic groups: differentiated carcinoma (well differentiated and moderately differentiated, WMD), poorly differentiated (PD), signet ring cell carcinoma (SRC), and mucinous carcinoma (MC).

RESULTS

The overall cumulative 5-year survival rates for patients were 67% for WMD, 54% for PD, 65% for SRC, and 48% for MC. The outcome of SRC was similar to that of WMD, whereas that of MC was similar to that of PD. Stage-stratified analysis revealed that histologic type was not statistically related to survival in patients with stage I, II, or III. On the other hand, histologic type in patients with stage IV disease was found to be significantly associated with survival.

CONCLUSIONS

Histologic classifications of mucin-producing gastric cancers should separately be considered from other histologic types.

摘要

背景与目的

胃癌可分为两种主要的组织学类型,即分化型和未分化型。在本研究中,我们试图阐明印戒细胞癌和黏液腺癌的预后及临床病理特征,这两种均为未分化型的黏液产生性肿瘤。

方法

我们回顾性分析了2275例行胃切除术患者的病历。病例分为四个组织学组:分化型癌(高分化和中分化,WMD)、低分化癌(PD)、印戒细胞癌(SRC)和黏液腺癌(MC)。

结果

患者的总体累积5年生存率分别为:WMD为67%,PD为54%,SRC为65%,MC为48%。SRC的预后与WMD相似,而MC的预后与PD相似。按分期分层分析显示,在Ⅰ期、Ⅱ期或Ⅲ期患者中,组织学类型与生存率无统计学相关性。另一方面,发现Ⅳ期患者的组织学类型与生存率显著相关。

结论

产生黏液的胃癌的组织学分类应与其他组织学类型分开考虑。

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