Imai Yasuo, Kurata Yoshihiro, Ichinose Masanori
Department of Diagnostic Pathology, Ota Memorial Hospital, SUBARU Health Insurance Society, 455-1 Oshima, Ota City 373-8585, Gunma, Japan.
Department of Digestive Surgery, Shioya Hospital, International University of Health and Welfare, Yaita City 329-2145, Tochigi, Japan.
J Pers Med. 2023 Apr 26;13(5):734. doi: 10.3390/jpm13050734.
The impact of venous invasion (VI) on postoperative recurrence in pathological (p)T1-3N0 clinical (c)M0 gastric cancer (GC) remains unclear. We investigated the association of VI grade with prognosis in 94 (78 stage I and 16 stage IIA) patients. VI was graded during pathological examinations based on the number of VIs per glass slide as follows: v0, 0; v1, 1-3; v2, 4-6; and v3, ≥7. Filling-type invasion in veins with a minor axis of ≥1 mm increased VI grade by 1. Four (4.3%) patients experienced recurrence. Recurrence increased with pT (pT1, 0.0%; pT2, 11.1%; pT3, 18.8%) and VI grade (v0, 0.0%; v1, 3.7%, v2, 14.3%; and v3, 40.0%). Recurrence was significantly more frequent in pT3 than pT1 and in v2 + v3 than v0 ( = 0.006 and 0.005, respectively). Kaplan-Meier curve analyses demonstrated a significant decrease in recurrence-free survival according to pT ( = 0.0021) and VI grade ( < 0.0001). Multivariate Cox analysis revealed a significant association of VI grade with recurrence ( = 0.049). These results suggest that VI grade is a potential recurrence predictor for pT1-3N0cM0 GC. No recurrence can be expected in cases with pT1 or VI grade v0. Adjuvant therapy might be considered for pT3 or VI grade v2 + v3.
静脉侵犯（VI）对病理分期（p）为T1-3、临床分期（c）为N0、M0的胃癌（GC）术后复发的影响尚不清楚。我们调查了94例（78例I期和16例IIA期）患者中VI分级与预后的相关性。在病理检查期间，根据每张玻片上VI的数量对VI进行分级，具体如下：v0，0个；v1，1-3个；v2，4-6个；v3，≥7个。静脉内短轴≥1 mm的充盈型侵犯使VI分级增加1级。4例（4.3%）患者出现复发。复发率随pT升高（pT1，0.0%；pT2，11.1%；pT3，18.8%）和VI分级升高（v0，0.0%；v1，3.7%；v2，14.3%；v3，40.0%）而增加。pT3期的复发明显比pT1期更频繁，v2 + v3级的复发明显比v0级更频繁（分别为P = 0.006和0.005）。Kaplan-Meier曲线分析表明，根据pT（P = 0.0021）和VI分级（P < 0.0001），无复发生存期显著降低。多因素Cox分析显示VI分级与复发有显著相关性（P = 0.049）。这些结果表明，VI分级是pT1-3N0cM0 GC潜在的复发预测指标。pT1期或VI分级为v0的病例预计不会复发。对于pT3期或VI分级为v2 + v3的病例，可能需要考虑辅助治疗。
