Cai Lei, Li Yan, Yang Xue-Wen, Lian Xiao, Guo Man, Xiao Shu-Ao, Wang Wen-Bin, Zhang Hong-Wei
Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University.
Department of Anesthesiology, Northwest Women's and Children's Hospital, Xi'an, China.
Onco Targets Ther. 2018 Feb 23;11:967-973. doi: 10.2147/OTT.S152614. eCollection 2018.
The mucinous component is a special histologic factor in gastric adenocarcinoma. The aim of this study was to assess the prognostic significance of mucinous component in gastric adenocarcinoma according to proportion.
Candidate patients with gastric adenocarcinoma were given radical D2 gastrectomies from September 2008 to May 2015 in our division. Clinicopathologic data and prognosis were monitored and analyzed among gastric adenocarcinoma patients with various proportions of mucinous component.
A total of 690 gastric adenocarcinomas with various proportions of mucinous component from 6,025 gastric adenocarcinoma patients were included. Higher numbers of patients with mucinous component came from: young patients, females, those with drinking history, at lower locations, Borrmann type III and IV, T4 stage, and positive for dissected lymph nodes. Tumors and pathological molecular markers showed more positivity in CEA, CA19-9, S100, and CD34. As the various proportions increased, more mucinous component seemed to be accompanied by more Borrmann type III and IV, T4 stage, and more positive expression of CEA and CA19-9. However, no significant difference in 5-year overall survival rate was observed among various proportions or existence of mucinous component. Also, proportion or existence of mucinous component was not an independent prognostic factor in multivariate analysis.
Mucinous component was not a prognostic factor for gastric adenocarcinoma after radical D2 gastrectomy, no matter what proportion the component comprised. However, gastric adenocarcinoma with mucinous component showed specific clinicopathological characteristics, such as more advanced tumor stage, different age and sex, and more positive rate of molecular markers, which might provide a new strategy for optimal individual diagnosis and therapies.
黏液成分是胃腺癌中一种特殊的组织学因素。本研究旨在根据黏液成分的比例评估其在胃腺癌中的预后意义。
2008年9月至2015年5月期间，我们科室对符合条件的胃腺癌患者实施了D2根治性胃切除术。对不同黏液成分比例的胃腺癌患者的临床病理数据及预后进行了监测与分析。
共纳入6025例胃腺癌患者中的690例具有不同黏液成分比例的胃腺癌病例。黏液成分比例较高的患者包括：年轻患者、女性、有饮酒史者、肿瘤位于较低部位者、Borrmann III型和IV型、T4期以及淋巴结清扫阳性者。肿瘤及病理分子标志物在癌胚抗原（CEA）、糖类抗原19-9（CA19-9）、S100和CD34中显示出更高的阳性率。随着黏液成分比例的增加，似乎更多的Borrmann III型和IV型、T4期以及CEA和CA19-9的阳性表达也随之增加。然而，不同黏液成分比例或黏液成分的存在与否在5年总生存率方面未观察到显著差异。此外，在多因素分析中，黏液成分的比例或存在与否并非独立的预后因素。
无论黏液成分占比如何，黏液成分都不是D2根治性胃切除术后胃腺癌的预后因素。然而，具有黏液成分的胃腺癌表现出特定的临床病理特征，如肿瘤分期更晚、年龄和性别差异、分子标志物阳性率更高，这可能为优化个体化诊断和治疗提供新策略。
