微卫星状态对根治性胃切除术后阴性淋巴结计数和预后相关性的影响。

Impact of microsatellite status on negative lymph node count and prognostic relevance after curative gastrectomy.

机构信息

Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Shanghai Minimally Invasive Surgery Center, Shanghai, China.

出版信息

J Surg Oncol. 2021 May;123 Suppl 1:S15-S24. doi: 10.1002/jso.26325. Epub 2021 Mar 2.

DOI:10.1002/jso.26325

PMID:33650696

Abstract

BACKGROUND AND OBJECTIVES

The impact of microsatellite instability-high (MSI-H) phenotype on lymph node yield after lymphadenectomy has never been discussed in gastric cancer (GC). In this study, we aimed to assess the association of microsatellite status with negative lymph node count (NLNC) as well as its prognostic value.

METHODS

We retrospectively analyzed 1491 GC patients and divided them into two groups: MSI-H (n = 141 [9.5%]) and microsatellite stability (MSS ) (n = 1350 [90.5%]). The NLNC and survival data were compared between the two groups. The log odds of positive lymph nodes (LNs) to negative LNs and the target lymph node examined threshold (TLNT) were calculated in both groups.

RESULTS

A statistically significant difference was found in median NLNC (26 vs. 23, p < .001) between MSI-H and MSS patients. MSI status was an independent factor for NLNC (p < .001). NLNC showed positive prognostic value for cases with metastatic lymph node (LN ) in both MSI-H and MSS groups. The TLNT for MSI-H and MSS were 33 and 26, respectively.

CONCLUSIONS

MSI-H was associated with higher NLNC in GC patients and this was independent of the presence of LN . However, more LNs are needed during pathological examination to capture LN cases in MSI-H

摘要

背景与目的

微卫星不稳定性高（MSI-H）表型对胃癌（GC）淋巴结清扫术后淋巴结检出率的影响尚未被讨论。在本研究中，我们旨在评估微卫星状态与阴性淋巴结计数（NLNC）的相关性及其预后价值。

方法

我们回顾性分析了 1491 例 GC 患者，并将其分为两组：MSI-H（n=141 [9.5%]）和微卫星稳定（MSS）（n=1350 [90.5%]）。比较两组间 NLNC 及生存数据。计算两组中阳性淋巴结（LNs）与阴性 LNs 的对数比值（odds ratio，OR）及目标淋巴结检查阈值（target lymph node examined threshold，TLNT）。

结果

MSI-H 与 MSS 患者的中位 NLNC 存在显著差异（26 对 23，p<0.001）。MSI 状态是 NLNC 的独立影响因素（p<0.001）。NLNC 对 MSI-H 和 MSS 患者的转移性淋巴结（LN）均具有阳性预后价值。MSI-H 和 MSS 的 TLNT 分别为 33 和 26。