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胃神经内分泌癌和腺癌根治性手术切除后的不同长期肿瘤学结局。

Different long-term oncologic outcomes after radical surgical resection for neuroendocrine carcinoma and adenocarcinoma of the stomach.

作者信息

Xie Jian-Wei, Lu Jun, Lin Jian-Xian, Zheng Chao-Hui, Li Ping, Wang Jia-Bin, Chen Qi-Yue, Cao Long-Long, Lin Mi, Tu Ru-Hong, Huang Chang-Ming

机构信息

Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, People's Republic of China.

出版信息

Oncotarget. 2017 Feb 18;8(34):57495-57504. doi: 10.18632/oncotarget.15488. eCollection 2017 Aug 22.

Abstract

PURPOSE

To explore differences in long-term outcomes between gastric neuroendocrine carcinoma (GNEC) and gastric adenocarcinoma (GAC).

METHODS

One hundred GNEC patients and 3089 GAC patients were enrolled. Differences in long-term outcomes between the groups were analyzed by 1:2 propensity score matching.

RESULTS

Statistically significant differences between the groups were noted in terms of gender, American Society of Anesthesiologists score, tumor size, T stage, N stage, TNM stage and surgical approach. However, differences were not significant after matching. The 3-year and 5-year overall survival rates for the GNEC group were reduced compared with those for the GAC group, though disease-free survival rates and mean recurrence times were similar. Notably, the mean post-recurrence survival of the GNEC group was significantly worse than that of the GAC group (5.2 . 14.8 months, <0.001). A strong negative correlation was found between a high Ki-67 labeling index and overall survival time. Cox regression analysis indicated the Ki-67 labeling index to be an independent factor influencing patient post-recurrence survival.

CONCLUSIONS

The long-term oncologic outcome of GNEC was worse than that of GAC, which may be relative to its reduced post-recurrence survival. A high Ki-67 labeling index was an independent factor influencing patient post-recurrence survival.

摘要

目的

探讨胃神经内分泌癌(GNEC)与胃腺癌(GAC)长期预后的差异。

方法

纳入100例GNEC患者和3089例GAC患者。通过1:2倾向评分匹配分析两组患者长期预后的差异。

结果

两组患者在性别、美国麻醉医师协会评分、肿瘤大小、T分期、N分期、TNM分期及手术方式方面存在统计学显著差异。然而,匹配后差异无统计学意义。GNEC组的3年和5年总生存率低于GAC组,尽管无病生存率和平均复发时间相似。值得注意的是,GNEC组复发后的平均生存时间显著短于GAC组(5.2对14.8个月,P<0.001)。高Ki-67标记指数与总生存时间呈强负相关。Cox回归分析表明,Ki-67标记指数是影响患者复发后生存的独立因素。

结论

GNEC的长期肿瘤学预后比GAC差,这可能与其复发后生存时间缩短有关。高Ki-67标记指数是影响患者复发后生存的独立因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f3b/5593661/d4a633158474/oncotarget-08-57495-g001.jpg

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