Cirugía General y Aparato Digestivo, Hospital Universitario de Cruces (OSI EE Cruces), SPAIN.
Anatomía Patológica, Hospital Universitario de Cruces (OSI EE Cruces).
Rev Esp Enferm Dig. 2021 May;113(5):324-331. doi: 10.17235/reed.2020.7184/2020.
since Lauren classified gastric cancer into intestinal-type adenocarcinoma and diffuse gastric carcinoma back in 1965, countless categorizations have been published that attempt to elucidate the clinicopathological and prognostic differences between histological subtypes.
a retrospective study was performed of gastric cancer cases managed in a third-level site over ten years in order to compare subtypes between the most widely used classifications (Lauren and World Health Organization [WHO]).
a comparative study of the most relevant clinicopathological characteristics and a multivariate survival analysis were performed.
significant differences exist between histological subtypes in terms of age, gender, location, extension, stage and treatment received. A univariate overall survival analysis revealed better survival rates for intestinal-type adenocarcinoma as compared to diffuse carcinoma (hazard ratio [HR]: 1.405 [1.024-1.927]) according to the Lauren's classification. Furthermore, there was a better prognosis of mucinous carcinoma (HR: 0.378 [0.164-0.868]), though failing to prove a poorer prognosis of poorly cohesive (HR: 1.242 [0.878-1.757]) and signet cell (HR: 1.354 [0.792-2.314]) carcinomas, according to the WHO classification. In the multivariate overall survival analysis, the following poor prognosis factors were identified: male gender, local infiltration (T), nodal invasion (N) and received adjuvant therapy.
although the various histological subtypes show significant clinicopathological differences, further studies are needed to compare them and clarify the prognostic relevance of each one.
自劳伦（Lauren）于 1965 年将胃癌分为肠型腺癌和弥漫型胃癌以来，已经发表了无数分类方法，试图阐明组织学亚型之间的临床病理和预后差异。
对三级医疗机构十年来管理的胃癌病例进行回顾性研究，以比较最广泛使用的分类（劳伦（Lauren）和世界卫生组织（WHO））之间的亚型。
对最相关的临床病理特征进行比较研究，并进行多变量生存分析。
在年龄、性别、部位、范围、分期和接受的治疗方面，组织学亚型之间存在显著差异。根据劳伦（Lauren）分类，肠型腺癌的总生存率优于弥漫型腺癌（危险比[HR]：1.405[1.024-1.927]）。此外，黏液腺癌的预后较好（HR：0.378[0.164-0.868]），尽管根据 WHO 分类，未证明低黏附性（HR：1.242[0.878-1.757]）和印戒细胞（HR：1.354[0.792-2.314]）癌的预后较差。在多变量总生存分析中，确定了以下预后不良因素：男性、局部浸润（T）、淋巴结侵犯（N）和接受辅助治疗。
尽管各种组织学亚型表现出显著的临床病理差异，但仍需要进一步研究来比较它们并阐明每种亚型的预后相关性。
