评估肿瘤芽在预测越南胃癌患者生存中的作用。
Evaluation of Tumor Budding in Predicting Survival for Gastric Carcinoma Patients in Vietnam.
机构信息
Department of Quan Su Optional Treatment, National Cancer Hospital, Hanoi, Vietnam.
Cancer Research and Clinical Trial Center, National Cancer Hospital, Hanoi, Vietnam.
出版信息
Cancer Control. 2020 Jan-Dec;27(1):1073274820968883. doi: 10.1177/1073274820968883.
BACKGROUND
Tumor budding (Bd) has been demonstrated to be a promising prognostic factor in many carcinomas and in gastric cancer. It may represent an optimal additional parameter that is helpful for risk stratification in gastric adenocarcinoma. Hence, the present research was designed to predict the survival outcomes of gastric cancer in Vietnam, applying the tumor budding criteria of the International Tumor Budding Consensus Conference (ITBCC) 2016.
METHODS
The present study was conducted on 109 gastric cancer patients who underwent surgery but did not receive neo-adjuvant chemotherapy from 2012 to 2015. The patients' clinicopathological features were recorded. Bd was evaluated according to the 2016 ITBCC criteria and classified as Bd1 (0-4 buds), Bd2 (5-9 buds), and Bd3 (≥10 buds) grades, in addition to being categorized into 2 main Bd groups: low (<10 buds) and high (≥10 buds) Bd. Kaplan-Meier and log-rank models were applied to analyze survival proportions.
RESULTS
Of all the patients, 22.9% were classified as Bd1, 31.2% as Bd2, and 45.9% as Bd3 grades. Furthermore, 54.1% patients were categorized into the low and 45.9% into the high Bd groups. Patients with Bd1 and Bd2 grades (the low Bd group) exhibited the best prognosis, with 5-year overall survival (OS) rates of 85.7%, 90.8%, and90.3%, respectively. Patients with Bd3 grade (the high Bd group exhibited the worst prognosis, and none of them lived for 5 years (p < 0.001). Similar to OS rates, disease-free survival (DFS) rates markedly reduced from the Bd1 to Bd3 grade: Bd1, 95.0%; Bd2, 84.7%; and Bd3, 0% (p < 0.001).
CONCLUSION
Patients with different gastric cancer Bd grades exhibited significantly different OS and DFS rates. The present study findings suggest that the ITBCC criteria can be used to stratify Bd for the treatment and prognosis of gastric cancer patients in Vietnam.
背景
肿瘤芽殖（Bd）已被证明是许多癌种和胃癌中很有前途的预后因素。它可能代表了一种最佳的附加参数，有助于对胃腺癌进行风险分层。因此，本研究旨在应用 2016 年国际肿瘤芽殖共识会议（ITBCC）的肿瘤芽殖标准来预测越南胃癌患者的生存结局。
方法
本研究纳入了 2012 年至 2015 年间接受手术但未接受新辅助化疗的 109 例胃癌患者。记录了患者的临床病理特征。根据 2016 年 ITBCC 标准评估 Bd，将其分为 Bd1（0-4 个芽殖）、Bd2（5-9 个芽殖）和 Bd3（≥10 个芽殖）级，并分为低（<10 个芽殖）和高（≥10 个芽殖）Bd 两个主要芽殖组。应用 Kaplan-Meier 和对数秩检验模型分析生存比例。
结果
所有患者中，22.9%为 Bd1 级，31.2%为 Bd2 级，45.9%为 Bd3 级。此外，54.1%的患者为低 Bd 组，45.9%为高 Bd 组。Bd1 和 Bd2 级（低 Bd 组）患者的预后最佳，5 年总生存率（OS）分别为 85.7%、90.8%和 90.3%。Bd3 级（高 Bd 组）患者的预后最差，无一人存活 5 年（p<0.001）。与 OS 率相似，无病生存率（DFS）也从 Bd1 级显著降低至 Bd3 级：Bd1 级为 95.0%；Bd2 级为 84.7%；Bd3 级为 0%（p<0.001）。
结论
不同胃癌 Bd 级别的患者 OS 和 DFS 率存在显著差异。本研究结果表明，ITBCC 标准可用于分层越南胃癌患者的 Bd，以进行治疗和预后评估。
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