Jiang Hao, Zhang Hongfeng, Tian Lantian, Zhang Xi, Xue Yingwei
Department of Gastrointestinal Surgery, the Third Affiliated Hospital of Harbin Medical University, Harbin, China, 150040.
Tumour Biol. 2013 Oct;34(5):2625-31. doi: 10.1007/s13277-013-0812-1. Epub 2013 May 1.
We investigated the clinical and pathological features as well as the prognosis of signet ring cell carcinoma (SRC) and gastric mucinous carcinoma (GMC) to lay a foundation for the management of these two diseases. Two thousand four hundred thirty gastric cancer patients, including 288 SRCs and 80 GMCs who had received a gastrectomy between 1997 and 2007, were retrospectively evaluated. There were significant differences in tumor location, distant metastasis status, lymph node dissection, depth of invasion, Borrmann type, pTNM stage, and pathological lymph node status between SRCs and GMC (P = 0.001, 0.003, 0.01, 0.0002, 0.0013, 0.0001, and 0.265, respectively). After prognostic analysis, the cases with GMC received a relatively low 5-year specific survival rate compared to SRC (58.68 % vs. 66.25 %; P = 0.064). After Cox regression analysis, gender, age, lymph node metastatic ratio, pTNM stage, curative operation, and distant metastasis were identified as the independent prognostic factors in SRC. On the other hand, pTNM stage and distant metastasis were identified as the independent prognostic factors in GMC. In conclusion, the clinical and pathological features as well as prognosis of GMC and gastric SRC differed. Therefore, the treatment of the two diseases should be individualized.
我们研究了印戒细胞癌(SRC)和胃黏液癌(GMC)的临床和病理特征以及预后情况,为这两种疾病的治疗奠定基础。对1997年至2007年间接受胃切除术的2430例胃癌患者进行回顾性评估,其中包括288例SRC患者和80例GMC患者。SRC和GMC在肿瘤位置、远处转移状态、淋巴结清扫情况、浸润深度、Borrmann分型、pTNM分期及病理淋巴结状态方面存在显著差异(P值分别为0.001、0.003、0.01、0.0002、0.0013、0.0001和0.265)。预后分析显示,GMC患者的5年特异性生存率相对低于SRC患者(58.68%对66.25%;P = 0.064)。Cox回归分析表明,性别、年龄、淋巴结转移率、pTNM分期、根治性手术及远处转移是SRC的独立预后因素。另一方面,pTNM分期和远处转移是GMC的独立预后因素。总之,GMC和胃SRC的临床病理特征及预后不同。因此,这两种疾病的治疗应个体化。