Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
World J Surg Oncol. 2022 Nov 30;20(1):374. doi: 10.1186/s12957-022-02853-2.
Remnant gastric cancer (RGC) has been increasing for various reasons such as a longer life span, medical progress, and others. It generally has a poor prognosis, and its mechanism of occurrence is unknown. The purpose of this study was to evaluate the clinicopathological features of and clarify the oncological features of RGC.
Between January 2002 and January 2017, 39 patients with RGC following distal gastrectomy underwent curative surgical resection at the Okayama University Hospital; their medical records and immunohistochemically stained extracted specimens were used for retrospective analysis.
On univariate analysis, initial gastric disease, pathological lymph node metastasis, and pathological stage were the significant factors associated with poor overall survival (p=0.014, 0.0061, and 0.016, respectively). Multivariate analysis of these 3 factors showed that only initial gastric disease caused by malignant disease was an independent factor associated with a poor prognosis (p=0.014, hazard ratio: 4.2, 95% confidence interval: 1.3-13.0). In addition, tumor-infiltrating CD8 T cells expression was higher in the benign disease group than in the malignant group (p=0.046).
Initial gastrectomy caused by malignant disease was an independent poor prognostic factor of RGC, and as one of the causes, lower level of tumor-infiltrating CD8 T cells in RGC may involve in.
由于寿命延长、医学进步等各种原因,残胃癌(RGC)的发病率一直在上升。它的预后通常较差,其发生机制尚不清楚。本研究旨在评估 RGC 的临床病理特征,并阐明其肿瘤学特征。
2002 年 1 月至 2017 年 1 月,在冈山大学医院对 39 例接受远端胃切除术后的 RGC 患者进行了根治性手术切除,使用这些患者的病历和免疫组化染色提取标本进行回顾性分析。
单因素分析显示,初始胃疾病、病理淋巴结转移和病理分期是与总体生存不良相关的显著因素(p=0.014、0.0061 和 0.016)。对这 3 个因素进行多因素分析显示,只有恶性疾病引起的初始胃疾病是与预后不良相关的独立因素(p=0.014,风险比:4.2,95%置信区间:1.3-13.0)。此外,良性疾病组肿瘤浸润 CD8 T 细胞的表达高于恶性疾病组(p=0.046)。
由恶性疾病引起的初始胃切除术是 RGC 的一个独立不良预后因素,作为其原因之一,RGC 中肿瘤浸润 CD8 T 细胞水平较低可能与之相关。