Xie Hong-hu, Lv Cheng-yu, Huang Wen-bin
Department of General Surgery, Nanjing Medical University Affiliated Nanjing First Hospital, Nanjing 210006, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2010 Jun;13(6):413-6.
To investigate the association between perineural invasion(PNI) and clinicopathological factors and the effect of PNI on overall survival in patients with gastric carcinoma.
A total of 178 patients with gastric carcinoma from January 2004 to May 2008 were analyzed retrospectively. Paraffin sections of surgical specimens from all the patients who underwent gastric resection were stained with laminin. PNI-positive was defined as infiltration of carcinoma cells into the perineurium or neural fascicles. The association of PNI with clinicopathologic features and prognosis of gastric carcinoma was studied.
PNI was positive in 78 of 178 patients(43.8%). The proportions of T stage, lymph node metastasis and TNM stage were significantly higher in PNI-positive group than those in PNI-negative group(all P<0.01). The PNI positive rate was correlated with the depth of gastric mural invasion and clinical stage. The overall survival in PNI-positive group was significantly lower than that in PNI-negative group by univariate analysis(P<0.01). The mean survival of PNI-positive patients(28.6 months) was significantly shorter than that of PNI-negative patients (44.3 months, P<0.01), which was also influenced by pN stage, pT stage, and clinical stage(P<0.01). By multivariable Cox proportional hazards model of overall survival, the positivity of PNI appeared to be an independent prognostic factor (hazards ratio=2.257, 95% CI:1.268-4.019, P=0.006).
PNI is associated with the degree of malignancy in gastric cancer. PNI can be a candidate of new prognostic factor.
探讨胃癌患者神经周围侵犯（PNI）与临床病理因素之间的关联以及PNI对总生存期的影响。
回顾性分析2004年1月至2008年5月期间的178例胃癌患者。对所有接受胃切除术患者的手术标本石蜡切片进行层粘连蛋白染色。PNI阳性定义为癌细胞浸润至神经束膜或神经束。研究PNI与胃癌临床病理特征及预后的关系。
178例患者中78例PNI阳性（43.8%）。PNI阳性组的T分期、淋巴结转移及TNM分期比例均显著高于PNI阴性组（均P<0.01）。PNI阳性率与胃壁浸润深度及临床分期相关。单因素分析显示，PNI阳性组的总生存期显著低于PNI阴性组（P<0.01）。PNI阳性患者的平均生存期（28.6个月）显著短于PNI阴性患者（44.3个月，P<0.01），且受pN分期、pT分期及临床分期影响（P<0.01）。通过总生存期的多变量Cox比例风险模型分析，PNI阳性似乎是一个独立的预后因素（风险比=2.257，95%可信区间：1.268-4.019，P=0.006）。
PNI与胃癌的恶性程度相关。PNI可作为新的预后因素候选指标。
