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可切除胃癌患者中淋巴管侵犯的预后意义:一项来自中国南方的大型回顾性研究。

The prognostic significance of lymphovascular invasion in patients with resectable gastric cancer: a large retrospective study from Southern China.

作者信息

Li Peng, He Hao-Qiang, Zhu Chong-Mei, Ling Yi-Hong, Hu Wan-Ming, Zhang Xin-Ke, Luo Rong-Zhen, Yun Jing-Ping, Xie Dan, Li Yuan-Fang, Cai Mu-Yan

机构信息

State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.

Department of Pathology, Sun Yat-sen University Cancer Center, No. 651, Dongfeng Road East, 510060, Guangzhou, China.

出版信息

BMC Cancer. 2015 May 7;15:370. doi: 10.1186/s12885-015-1370-2.

Abstract

BACKGROUND

The focus of this study was to assess the impact of lymphovascular invasion (LVI) on both the recurrence of cancer and the long-term survival of Chinese patients with resectable gastric cancer (GC).

METHODS

A retrospective analysis of the clinicopathological data for 1148 GC patients who had undergone gastrectomy with regional lymphadenectomy was performed. The primary objective was to assess the correlation between LVI and post-surgery outcomes for each patient. This was done by routine H & E staining for LVI on patients' disease-free survival (DFS) and disease-specific survival (DSS).

RESULTS

LVI was detected in 404 (35.2%) of the 1148 GC patients. The presence of LVI was significantly correlated with the level of CA19-9, the tumor size, the Lauren classification, tumor differentiation, gastric wall invasive depth, lymph node involvement, distant metastasis and an advanced TNM stage. There was a lower DFS and DSS in the patients with LVI as compared to the patients without LVI. A multivariate analysis also identified LVI as an independent prognostic factor of both DSS and DFS.

CONCLUSIONS

The presence of LVI is a risk factor for the recurrence of cancer and an independent indicator of a poor outcome in GC patients following surgery. The LVI status should be taken into consideration when determining the best approach for the treatment of the individual.

摘要

背景

本研究的重点是评估淋巴管侵犯(LVI)对中国可切除胃癌(GC)患者癌症复发和长期生存的影响。

方法

对1148例行胃切除术并进行区域淋巴结清扫的GC患者的临床病理资料进行回顾性分析。主要目的是评估每位患者LVI与术后结局之间的相关性。这是通过对患者的无病生存期(DFS)和疾病特异性生存期(DSS)进行LVI的常规苏木精和伊红染色来完成的。

结果

1148例GC患者中有404例(35.2%)检测到LVI。LVI的存在与CA19-9水平、肿瘤大小、劳伦分类、肿瘤分化、胃壁浸润深度、淋巴结受累、远处转移及晚期TNM分期显著相关。与无LVI的患者相比,有LVI的患者DFS和DSS较低。多因素分析也确定LVI是DSS和DFS的独立预后因素。

结论

LVI的存在是癌症复发的危险因素,也是GC患者术后预后不良的独立指标。在确定个体最佳治疗方法时应考虑LVI状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e397/4435771/b95b28cfe98b/12885_2015_1370_Fig1_HTML.jpg

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