Department of Surgery, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, Ruijin er Road, No. 197, 200025, Shanghai, China.
Anticancer Agents Med Chem. 2013 Feb;13(2):227-34. doi: 10.2174/1871520611313020007.
To determine the correlation of histopathological classification and patient outcomes, we performed a meta-analysis of histological subtypes on postoperative survival in gastric cancer.
A dataset composed of 11073 gastric cancers from 21 publications, combined with our cohort was included in the metaanalysis. We evaluated the association between the 5-year survival rate and the subtypes of gastric cancer based on histological grading or Lauren classification. All literatures were from Pubmed and Embase (up to December 2011).
In our cohort from Shanghai Ruijin Hospital, the differentiated gastric cancer revealed a significantly higher accumulative 5-year survival rate, compared to that in poor-differentiated cases (62.6% vs 44.8%, P < 0.001). Intestinal-type gastric cancer shown a higher accumulative 5-year survival rate, compared to that in diffuse-type cases (61.7% vs 41.1%, P < 0.001). In overall meta-analysis, the poordifferentiated gastric cancer significantly increased the postoperative 5-year death risk, compared to the differentiated cases (OR=1.24, 95% CI 1.13-1.36, P < 0.001). The 5-year death risk was increased in the diffuse-type cases relative to the intestinal-type cases (OR=1.29, 95% CI 1.11-1.49, P < 0.001).
Gastric cancer with a differentiated histology or intestinal-type shows a better prognosis than individual with a poordifferentiated histology or a diffuse-type. Accurate histologic classification is desirable for gastric cancer handling.
为了确定组织病理学分类与患者预后的相关性，我们对胃癌术后生存的组织学亚型进行了荟萃分析。
纳入了 21 项研究的 11073 例胃癌病例数据集，其中包括我们的队列，纳入分析的病例均来自 Pubmed 和 Embase（截至 2011 年 12 月）。我们评估了基于组织学分级或 Lauren 分类的胃癌组织学亚型与 5 年生存率之间的关系。
在我们来自上海瑞金医院的队列中，与低分化胃癌相比，分化型胃癌的 5 年累积生存率明显更高（62.6%比 44.8%，P<0.001）。肠型胃癌的 5 年累积生存率高于弥漫型胃癌（61.7%比 41.1%，P<0.001）。在总体荟萃分析中，与分化型胃癌相比，低分化型胃癌显著增加了术后 5 年的死亡风险（OR=1.24，95%CI 1.13-1.36，P<0.001）。与肠型胃癌相比，弥漫型胃癌的 5 年死亡风险增加（OR=1.29，95%CI 1.11-1.49，P<0.001）。
具有分化型组织学或肠型组织学的胃癌比具有低分化型组织学或弥漫型组织学的胃癌具有更好的预后。对胃癌进行准确的组织学分类是可取的。
