Gulluoglu Mine, Yegen Gulcin, Ozluk Yasemin, Keskin Metin, Dogan Serap, Gundogdu Gökçen, Onder Semen, Balik Emre
Faculty of Medicine, Istanbul University, Istanbul, Turkey
Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Int J Surg Pathol. 2015 Aug;23(5):349-58. doi: 10.1177/1066896915581200. Epub 2015 Apr 24.
The most important prognostic factor for early gastric cancer (EGC) is the lymph node status. It is important to predict early lesions without lymph node metastasis (LNM) before proceeding to radical surgery in locally excised lesions. Tumor budding is a feature known to be related to aggressive tumor behavior in several solid tumors. We aimed to assess the predictive value of tumor budding for LNM in pT1a and pT1b gastric cancer.
We retrospectively investigated radical gastrectomy specimens for of 126 EGC patients and assess the possible relation between the clinicopathologic features, including age, gender, tumor location, tumor size, macroscopic tumor type, histologic differentiation, depth and width of submucosal invasion, lymphovascular invasion, and tumor budding with lymph node involvement.
Among the 126 EGCs, 38 were stages as pT1a and 88 as pT1b. LNM rate in pT1a tumors was 13% whereas it was 33% in pT1b tumors. Tumor budding was the only factor significantly and independently related to LNM in pT1a patients. Female gender and tumor budding were found to be independent risk factors in pT1b group. Other clinicopathologic features were not related to LNM.
Based on these results, we suggest that budding is a promising parameter to assess for prediction of LNM in EGC removed by endoscopic surgery, and to decide on the appropriate surgical approach.
早期胃癌（EGC）最重要的预后因素是淋巴结状态。在对局部切除的病变进行根治性手术之前，预测无淋巴结转移（LNM）的早期病变很重要。肿瘤芽生是一种已知与几种实体瘤的侵袭性肿瘤行为相关的特征。我们旨在评估肿瘤芽生对pT1a和pT1b期胃癌LNM的预测价值。
我们回顾性研究了126例EGC患者的根治性胃切除标本，并评估了包括年龄、性别、肿瘤位置、肿瘤大小、大体肿瘤类型、组织学分化、黏膜下浸润深度和宽度、淋巴管浸润以及肿瘤芽生与淋巴结受累之间的可能关系。
在126例EGC中，38例为pT1a期，88例为pT1b期。pT1a期肿瘤的LNM率为13%，而pT1b期肿瘤为33%。肿瘤芽生是pT1a期患者中与LNM显著且独立相关的唯一因素。在pT1b组中，女性性别和肿瘤芽生被发现为独立危险因素。其他临床病理特征与LNM无关。
基于这些结果，我们建议芽生是评估内镜手术切除的EGC中LNM预测以及决定合适手术方式的一个有前景的参数。
