肿瘤大小可预测黏液型胃癌的生存情况。

Tumor size predicts survival in mucinous gastric carcinoma.

机构信息

Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

J Surg Oncol. 2012 Nov;106(6):757-64. doi: 10.1002/jso.23141. Epub 2012 Apr 25.

DOI:10.1002/jso.23141

PMID:22535583

Abstract

BACKGROUND

Mucinous gastric carcinoma (MGC) is a distinct histologic subtype of gastric cancer. However, the prognostic significances of the current TNM staging system and histology in MGC have not been studied.

METHODS

206 patients who underwent R0 resection for MGC were classified by tumor size (<3 cm as T1; ≥ 3-5 cm as T2; ≥ 5-9 cm as T3; and ≥ 9 cm as T4). Immunohistochemistry for EGFR and HER2 was also performed.

RESULTS

Tumor sizes ranged from 1.2 to 21.0 cm (median 6.2 cm). Large tumor size (≥ 5 cm) was significantly associated with older patient age, deeper invasion depth, and more frequent lymph node metastasis (P < 0.05). Tumor size was a significant prognostic factor in both univariate (P < 0.001) and multivariate (P < 0.04) analyses. However, depth of invasion was not significant in multivariate analyses. A modified staging system based on tumor size predicted survival more accurately than did the conventional TNM staging system. We verified our results in an independent validation cohort of 123 MGC patients. Overexpression of either EGFR or HER2 was rare.

CONCLUSIONS

In MGCs, tumor size is an independent prognostic factor and a modified TNM system based on tumor size predicted survival accurately.

摘要

背景

黏液型胃癌（MGC）是一种独特的胃癌组织学亚型。然而，目前的 TNM 分期系统和组织学在 MGC 中的预后意义尚未得到研究。

方法

对 206 例接受 R0 切除的 MGC 患者进行分类，根据肿瘤大小（<3cm 为 T1；≥3-5cm 为 T2；≥5-9cm 为 T3；≥9cm 为 T4）。还对 EGFR 和 HER2 进行了免疫组织化学检测。

结果

肿瘤大小范围为 1.2 至 21.0cm（中位数 6.2cm）。大肿瘤大小（≥5cm）与患者年龄较大、浸润深度较深和淋巴结转移更频繁显著相关（P<0.05）。肿瘤大小在单因素（P<0.001）和多因素（P<0.04）分析中均为显著的预后因素。然而，浸润深度在多因素分析中并不显著。基于肿瘤大小的改良分期系统比传统的 TNM 分期系统更能准确地预测生存。我们在 123 例 MGC 患者的独立验证队列中验证了我们的结果。EGFR 或 HER2 的过表达很少见。