Garnier P, Vielh P, Asselain B, Durand J C, Girodet J, Pilleron J P, Salmon R J
Service de Chirurgie Générale, Institut Curie, Paris.
Gastroenterol Clin Biol. 1988 Jun-Jul;12(6-7):553-8.
Of the various pathology classifications for gastric carcinoma, those of Lauren and of Ming have been claimed to be of prognostic value. We therefore reviewed the charts of 101 patients (mean age 64 +/- 11 years) treated for gastric carcinoma between 1960 and 1983 at the Institut Curie. We excluded the following patients: 1) those with distant metastases; 2) those who were not operated on; 3) those who underwent laparotomy only, and 4) those who had a palliative procedure. The type of surgery performed was partial gastrectomy in 73 cases and total gastrectomy in 28. Pathology was reviewed according to the WHO, Lauren, and Ming classifications. Were taken into consideration: 1) whether the surgeon believed that removal of tumor was grossly complete or not, 2) the degree of parietal involvement according the pTNM classification system, and 3) the number of positive lymph nodes. Survival was analyzed by the Kaplan Meier method after exclusion of all postoperative deaths. Mean overall survival was 30 months, while that for patients undergoing grossly complete removal of tumor was 34 months. In univariate analysis, no correlation was found between survival and pathology according to Lauren's or Ming's classifications, sex, parietal involvement, or age. Survival was statistically correlated with the size of the tumor (p = 0.015), the gross completeness of surgery (p = 0.008), the type of surgery performed (prognosis was better after partial gastrectomy than after total gastrectomy) and the number of positive lymph nodes (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
在胃癌的各种病理分类中,劳伦(Lauren)分类法和明(Ming)分类法被认为具有预后价值。因此,我们回顾了1960年至1983年间在居里研究所接受胃癌治疗的101例患者(平均年龄64±11岁)的病历。我们排除了以下患者:1)有远处转移的患者;2)未接受手术的患者;3)仅接受剖腹手术的患者;4)接受姑息性手术的患者。所进行的手术类型为73例部分胃切除术和28例全胃切除术。根据世界卫生组织(WHO)、劳伦分类法和明分类法对病理进行了复查。考虑的因素有:1)外科医生是否认为肿瘤大体切除完整;2)根据pTNM分类系统的壁层受累程度;3)阳性淋巴结的数量。在排除所有术后死亡病例后,采用Kaplan Meier方法分析生存率。总体平均生存期为30个月,而肿瘤大体完整切除的患者平均生存期为34个月。在单因素分析中,未发现生存率与劳伦或明分类法的病理、性别、壁层受累情况或年龄之间存在相关性。生存率与肿瘤大小(p = 0.015)、手术的大体完整性(p = 0.008)、所进行的手术类型(部分胃切除术后的预后优于全胃切除术后)以及阳性淋巴结数量(p = 0.0001)在统计学上相关。(摘要截短于250字)