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与接受手术切除的胃癌患者肿瘤结节存在相关的临床病理因素。

Clinicopathological factors associated with the presence of tumor deposits in resected gastric cancer patients.

作者信息

Paredes Torres Oscar, Prado Cucho Sofia, Taxa Rojas Luis, Luque-Vasquez Carlos, Chavez Ivan, Payet Meza Eduardo, Ruiz Figueroa Eloy, Berrospi Espinoza Francisco

机构信息

Department of Abdominal Surgery, National Institute of Neoplastic Diseases INEN, Lima Peru.

Department of Pathology, National Institute of Neoplastic Disease INEN, Lima Peru.

出版信息

Heliyon. 2021 May 29;7(6):e07185. doi: 10.1016/j.heliyon.2021.e07185. eCollection 2021 Jun.

Abstract

PURPOSE

The role of tumor deposits (TDs) in the staging of gastric cancer is currently debatable. TDs are defined as tumoral nodules in perigastric adipose tissue with no evidence of lymphatic, vascular, or neural structures. Clinicopathological factors related to the presence of TDs are not well defined. This study aimed to identify the clinicopathological factors associated with the presence of TDs in resected gastric cancer patients.

MATERIALS AND METHODS

This prospective study included patients diagnosed with gastric cancer and treated with D2 radical gastrectomy from January 2019 to January 2020. Univariate and multivariate analyses were performed to determine the factors related to the presence of TDs.

RESULTS

A total of 111 patients were eligible and TDs were present in 31 of them (28%). In the univariate analysis, male gender (p = 0.027), tumor size ≥ 5cm (p = ≤0.001), serosa and adjacent organs invasion (pT4a and pT4b) (p = ≤0.001), ≥16 metastatic lymph nodes (pN3b) (p = ≤0.001), and TNM stage III tumors (p = ≤0.001) were significantly associated with the presence of TDs. The multivariate analysis showed that a tumors size ≥5 cm (OR = 3.69, 95% CI: 1.17-11.6), serosa and adjacent organs invasion (pT4a and pT4b) (OR = 3.78, 95% CI: 1.31-10.86) and ≥16 metastatic lymph nodes (pN3b) (OR = 3.21, 95%CI:1.06-9.7) were independent risk factors for the presence of TDs.

CONCLUSIONS

Larger tumors (tumor size ≥ 5cm), serosa and adjacent organs invasion (pT4 and pT4b), and ≥16 metastatic lymph nodes (pN3b) were independent risk factors for the presence of TDs.

摘要

目的

肿瘤沉积物(TDs)在胃癌分期中的作用目前存在争议。TDs被定义为胃周脂肪组织中的肿瘤结节,且无淋巴、血管或神经结构的证据。与TDs存在相关的临床病理因素尚未明确界定。本研究旨在确定接受手术切除的胃癌患者中与TDs存在相关的临床病理因素。

材料与方法

本前瞻性研究纳入了2019年1月至2020年1月期间被诊断为胃癌并接受D2根治性胃切除术的患者。进行单因素和多因素分析以确定与TDs存在相关的因素。

结果

共有111例患者符合条件,其中31例(28%)存在TDs。在单因素分析中,男性(p = 0.027)、肿瘤大小≥5cm(p =≤0.001)、浆膜及邻近器官侵犯(pT4a和pT4b)(p =≤0.001)、≥16个转移淋巴结(pN3b)(p =≤0.001)以及TNM分期为III期的肿瘤(p =≤0.001)与TDs的存在显著相关。多因素分析显示,肿瘤大小≥5cm(OR = 3.69,95%CI:1.17 - 11.6)、浆膜及邻近器官侵犯(pT4a和pT4b)(OR = 3.78,95%CI:1.31 - 10.86)以及≥16个转移淋巴结(pN3b)(OR = 3.21,95%CI:1.06 - 9.7)是TDs存在的独立危险因素。

结论

较大的肿瘤(肿瘤大小≥5cm)、浆膜及邻近器官侵犯(pT4和pT4b)以及≥16个转移淋巴结(pN3b)是TDs存在的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6eef/8188374/9c88c2bf9841/gr1.jpg

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