Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Minimally Invasive Surgery Center, Shanghai, China.
J Surg Oncol. 2021 May;123 Suppl 1:S15-S24. doi: 10.1002/jso.26325. Epub 2021 Mar 2.
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.
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.
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.
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
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。
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）。
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。
MSI-H 与 GC 患者的 NLNC 较高有关，这与 LN 的存在无关。然而，在 MSI-H 患者中需要进行更多的淋巴结病理检查，以捕获 LN 病例。
