Division of Digestive Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
Gastric Cancer. 2012 Apr;15(2):179-87. doi: 10.1007/s10120-011-0094-5. Epub 2011 Oct 12.
Invasive micropapillary carcinoma has been recognized as a rare disease entity with aggressive tumor behavior. However, few reports have described invasive micropapillary carcinoma in the gastrointestinal tract, particularly its involvement in gastric cancer.
We retrospectively analyzed 930 patients diagnosed with gastric cancer who underwent gastrectomy, and we then histopathologically evaluated the existence of a regional invasive micropapillary component. Clinicopathological features were investigated in patients with an invasive micropapillary component and compared with such features in 100 patients with gastric adenocarcinoma, selected as stage-matched controls, who underwent gastrectomy during the same period.
Of the 930 patients, 14 were histopathologically diagnosed with gastric cancer with a regional invasive micropapillary component. There were no significant differences in age, gender, tumor location, macroscopic type, or type of surgery between patients with an invasive micropapillary component and the pT-matched controls. Histopathologically, significant differences were observed in lymphatic infiltration, venous invasion, the percentage of cases with lymph node metastasis, and the median number of metastatic lymph nodes. The three-year disease-free and overall survival rates of patients with an invasive micropapillary component were 40.5 and 59.3%, respectively, compared with those for the stage-matched controls, which were 72.6 and 80.6%, respectively (p = 0.02 and 0.07).
Patients with gastric cancer with a regional invasive micropapillary component showed marked cancer infiltration in the lymphatic pathway and poor prognosis after gastrectomy.
浸润性微乳头状癌已被认为是一种具有侵袭性肿瘤行为的罕见疾病实体。然而,很少有报道描述胃肠道中的浸润性微乳头状癌,特别是其在胃癌中的涉及。
我们回顾性分析了 930 例接受胃切除术的胃癌患者,并对存在区域性浸润性微乳头状成分的患者进行了组织病理学评估。我们研究了具有浸润性微乳头状成分的患者的临床病理特征,并与同期接受胃切除术的 100 例胃癌患者(选择为分期匹配对照)的特征进行了比较。
在 930 例患者中,有 14 例被组织病理学诊断为具有区域性浸润性微乳头状成分的胃癌。具有浸润性微乳头状成分的患者与 pT 匹配对照患者在年龄、性别、肿瘤位置、大体类型或手术类型方面无显著差异。组织病理学上,在淋巴管浸润、静脉侵犯、淋巴结转移的病例百分比以及转移淋巴结的中位数方面存在显著差异。具有浸润性微乳头状成分的患者的三年无病生存率和总生存率分别为 40.5%和 59.3%,而分期匹配对照患者的三年无病生存率和总生存率分别为 72.6%和 80.6%(p=0.02 和 0.07)。
具有区域性浸润性微乳头状成分的胃癌患者在淋巴管途径中表现出明显的癌症浸润,并且在胃切除术后预后不良。