早期和晚期胃癌中印戒细胞腺癌的临床病理差异。
Clinicopathological differences in signet ring cell adenocarcinoma between early and advanced gastric cancer.
机构信息
Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
出版信息
Gastric Cancer. 2019 Mar;22(2):255-263. doi: 10.1007/s10120-018-0860-8. Epub 2018 Aug 1.
BACKGROUND
Signet ring cell adenocarcinoma is a histological classification based on the WHO classification. The presence of this specific histological type is associated with a worse pathological appearance. The prognosis of signet ring cell adenocarcinoma in gastric cancer patients after curative surgery is still under debate.
METHODS
From January 1988 to December 2012, a total of 2971 patients, including 819 early and 2152 advanced gastric cancer patients underwent curative resection for gastric cancer. Among them, there were 185 cases of signet ring cell adenocarcinoma in early gastric cancer patients, while there were 570 cases in advanced gastric cancer patients.
RESULTS
The overall incidence of signet ring cell adenocarcinoma was 25.4%. Our results showed that the 5-year overall survival rates of early gastric cancer patients with signet ring cell adenocarcinoma and non-signet ring cell adenocarcinoma were 90.7 and 83.2%, respectively (P = 0.001). The 5-year disease-free survival rates of early gastric cancer patients with signet ring cell adenocarcinoma and non-signet ring cell adenocarcinoma were 87.4 and 81.6%, respectively (P = 0.003). The 5-year overall survival rates of advanced gastric cancer patients with signet ring cell adenocarcinoma and non-signet ring cell adenocarcinoma were 32.1 and 37.9%, respectively (P = 0.041). The 5-year disease-free survival rates of advanced gastric cancer patients with signet ring cell adenocarcinoma and non-signet ring cell adenocarcinoma were 28.6 and 35.2%, respectively (P = 0.037). Signet ring cell adenocarcinoma was an independent predictor for overall survival in advanced gastric cancer (P = 0.017).
CONCLUSION
The clinical features and prognosis of signet ring cell adenocarcinoma are different between early and advanced gastric cancer. Signet ring cell adenocarcinoma is a poor prognostic factor in advanced gastric cancer after curative resection.
背景
印戒细胞腺癌是一种基于世界卫生组织分类的组织学分类。这种特殊组织学类型的存在与更差的病理表现相关。根治性手术后胃印戒细胞腺癌患者的预后仍存在争议。
方法
1988 年 1 月至 2012 年 12 月，共有 2971 例患者接受了胃癌根治性切除术，其中 819 例为早期胃癌患者，2152 例为晚期胃癌患者。其中，早期胃癌患者中有 185 例为印戒细胞腺癌，晚期胃癌患者中有 570 例。
结果
印戒细胞腺癌的总发生率为 25.4%。我们的结果表明，印戒细胞腺癌和非印戒细胞腺癌早期胃癌患者的 5 年总生存率分别为 90.7%和 83.2%（P=0.001）。印戒细胞腺癌和非印戒细胞腺癌早期胃癌患者的 5 年无病生存率分别为 87.4%和 81.6%（P=0.003）。印戒细胞腺癌和非印戒细胞腺癌晚期胃癌患者的 5 年总生存率分别为 32.1%和 37.9%（P=0.041）。印戒细胞腺癌和非印戒细胞腺癌晚期胃癌患者的 5 年无病生存率分别为 28.6%和 35.2%（P=0.037）。印戒细胞腺癌是晚期胃癌患者总生存的独立预测因素（P=0.017）。
结论
印戒细胞腺癌在早期和晚期胃癌中的临床特征和预后不同。印戒细胞腺癌是根治性手术后晚期胃癌的预后不良因素。
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