Dong Caixia, Jiang Mengjie, Tan Yinuo, Kong Yiyao, Yang Ziru, Zhong Chenhan, Li Dan, Yuan Ying
Department of Medical Oncology Department of Surgical Oncology Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, Chinese National Ministry of Education; Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Medicine (Baltimore). 2016 Aug;95(34):e4720. doi: 10.1097/MD.0000000000004720.
Primary gastric squamous cell carcinoma (SCC) is an exceedingly rare disease. We increased the understanding of gastric SCC and evaluated prognostic factors of gastric SCC.In this large-population cohort study, we retrospectively collected 163 primary gastric SCC and 66,209 primary gastric adenocarcinoma cases from the surveillance, epidemiology, and end results program (SEER) database from 1988 to 2012. The Chi-squared test demonstrated the distributed differences. Cox proportional hazards regression model was used to evaluate the prognostic factors.Gastric SCC accounted for 0.2% of all the primary gastric cancer cases. The mean age of patients with gastric SCC was 69.6 years old, and the man-to-woman ratio was 2.3:1. The proportion of black was higher in gastric SCC than gastric adenocarcinoma (P < 0.001). Almost half of the gastric SCCs were diagnosed in stage IV and more than half were poorly differentiated. In gastric SCC, the median survival was 8.0 months and the 5-year overall survival (OS) was 32.7%; in gastric adenocarcinoma the median survival rate was 19.0 months and the 5-year OS was 35.4%. The multivariate analysis showed that number of primary lesions, tumor location, grade, and stage were independent prognostic factors in gastric SCC. The tumor stage was the most important prognostic factor.Primary gastric SCC is exceedingly rare. Compared with gastric adenocarcinoma, gastric SCC was more frequent in black patients and was usually diagnosed when it was poorly differentiated and at a later stage. On the whole, gastric SCC has a poorer outcome. Disease stage is likely a key determinant in survival.
原发性胃鳞状细胞癌(SCC)是一种极为罕见的疾病。我们增进了对胃SCC的了解,并评估了胃SCC的预后因素。在这项大样本队列研究中,我们从监测、流行病学和最终结果计划(SEER)数据库中回顾性收集了1988年至2012年的163例原发性胃SCC和66209例原发性胃腺癌病例。卡方检验显示了分布差异。采用Cox比例风险回归模型评估预后因素。胃SCC占所有原发性胃癌病例的0.2%。胃SCC患者的平均年龄为69.6岁,男女比例为2.3:1。胃SCC中黑人的比例高于胃腺癌(P<0.001)。几乎一半的胃SCC在IV期被诊断出来,一半以上分化不良。在胃SCC中,中位生存期为8.0个月,5年总生存率(OS)为32.7%;在胃腺癌中,中位生存率为19.0个月,5年OS为35.4%。多因素分析显示,原发灶数量、肿瘤位置、分级和分期是胃SCC的独立预后因素。肿瘤分期是最重要的预后因素。原发性胃SCC极为罕见。与胃腺癌相比,胃SCC在黑人患者中更为常见,通常在分化不良且处于晚期时被诊断出来。总体而言,胃SCC的预后较差。疾病分期可能是生存的关键决定因素。