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肿瘤沉积物:对胃癌患者的预后意义

Tumor deposits: Prognostic significance in gastric cancer patients.

作者信息

Yildiz Bulent, Etiz Durmus, Dal Pinar, Junushova Bermet, Pasaoglu Ozgul, Yilmaz Evrim, Erkasap Serdar, Dincer Murat

机构信息

Department of Medical Oncology, Eskisehir Osmangazi University, Eskisehir, Turkey.

出版信息

J BUON. 2016 Nov-Dec;21(6):1476-1481.

Abstract

PURPOSE

Tumor deposits (TDs) are defined as satellite peritumoral nodules in the peritumoral adipose tissue of a primary carcinoma without histologic evidence of residual lymph node in the nodule. We aimed to investigate the relation between TDs and clinicopathological characteristics of gastric cancer and to evaluate the effect of TDs on prognosis.

METHODS

One hundred and seven non-metastatic gastric cancer patients were enrolled. The relationships between positive and negative TDs with respect to clinicopathological characteristics, as well as disease free survival (DFS) and overall survival (OS), were analyzed.

RESULTS

TDs were detected in 28 patients (26.2%). Advanced pT stage and pN stage were significantly higher in TDs-positive compared to TDs-negative patients (p=0.015 and p=0.037, respectively). No significant differences were identified between the groups in other clinicopathological variables such as gender, lymphovascular and perineural invasion. Recurrence and mortality rates were higher in the TDs-positive patients during follow-up of both groups (22/78.6% vs 38/48.1%, p=0.010 for relapse; 20/71.4% vs 3/38%, p=0.005 for mortality). The univariate analysis demonstrated shorter DFS and OS for TDs-positive compared to TDs-negative patients. In multivariate analysis, TDs-positive patients had 1.75-fold higher likelihood to develop recurrence, while the likelihood of death increased 1.99-fold (p=0.041 and p=0.020, respectively).

CONCLUSION

TDs-positive gastric cancers demonstrate a more aggressive clinical course compared to TDs-negative. More effective treatment methods should be necessary for management of this subgroup of gastric cancer.

摘要

目的

肿瘤沉积物(TDs)被定义为原发性癌瘤旁脂肪组织中的卫星状瘤旁结节,结节内无残留淋巴结的组织学证据。我们旨在研究TDs与胃癌临床病理特征之间的关系,并评估TDs对预后的影响。

方法

纳入107例非转移性胃癌患者。分析了TDs阳性和阴性与临床病理特征以及无病生存期(DFS)和总生存期(OS)之间的关系。

结果

28例患者(26.2%)检测到TDs。与TDs阴性患者相比,TDs阳性患者的晚期pT分期和pN分期显著更高(分别为p=0.015和p=0.037)。在性别、淋巴管和神经周围侵犯等其他临床病理变量方面,两组之间未发现显著差异。在两组随访期间,TDs阳性患者的复发率和死亡率更高(复发:22/78.6%对38/48.1%,p=0.010;死亡:20/71.4%对3/38%,p=0.005)。单因素分析表明,与TDs阴性患者相比,TDs阳性患者的DFS和OS更短。多因素分析显示,TDs阳性患者复发的可能性高1.75倍,死亡的可能性增加1.99倍(分别为p=0.041和p=0.020)。

结论

与TDs阴性的胃癌相比,TDs阳性的胃癌临床病程更具侵袭性。对于这一亚组胃癌的治疗,需要更有效的治疗方法。

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