血管侵犯是胃癌的一个危险因素：一项回顾性分析研究。

Vessel invasion is a risk factor for gastric cancer: a retrospective analysis study.

作者信息

Wang Qiannan, Liu Zhaorui, Han Jiangbo, Gao Yuan, Shao Yun, Cai Hui, Yin Kai

机构信息

Department of Gastrointestinal Surgery, Navy Medical University First Affiliated Hospital, Shanghai, China.

出版信息

World J Surg Oncol. 2024 Dec 27;22(1):348. doi: 10.1186/s12957-024-03604-1.

DOI:10.1186/s12957-024-03604-1

PMID:39726014

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11673728/

Abstract

OBJECTIVE

To explore the relationship between vessel invasion (VI) and clinicopathological features and prognosis in patients with gastric cancer (GC).

METHODS

A total of 3600 cases of patients with GC who underwent radical gastrectomy in gastrointestinal surgery department of the First Affiliated Hospital of Naval Medical University from June 2014 to June 2019 were retrospectively analyzed, and filtering them based on specific inclusion and exclusion criteria. To reduce the possibility of selection bias about the impact of VI, patients were divided into two groups according to the presence or absence of it, and performed a one-to-one propensity score matching (PSM), resulting in 724 patients in each group. In the analysis of data from 3,205 GC patients was employed to examine inter-group variations in VI positivity across diverse clinicopathological factors. Both univariate and multivariate Cox regression models were applied to investigate the correlation between clinicopathological factors and prognosis. The findings were further illustrated through the plotting of Kaplan-Meier survival curves.

RESULTS

3205 patients were included in this study, of which 989 (30.9%) were VI-positive and 2216 (69.1%) were VI-negative. VI-positive group was found to be significantly associated with age, body mass index (BMI), pTNM stage, tumor location, perineural invasion (PI), Lauren classfication and tumor deposit (TD) (P < .05), but not with gender or basic disease. VI-positive patients had a worse survival than VI-negative patients before (P < .001) and after (P = .007) PSM matching. The Kaplan-Meier survival curve after PSM illustrated that patients with VI had a 5-year survival rate of 58.03%, whereas patients without VI had a higher rate at 66.25%. Further, multivariate analysis after matching demonstrated that VI was an independent risk factor for prognosis (P = .030).

CONCLUSION

VI is associated with multiple pathological factors and serves as an independent risk factor affecting the prognosis of GC.

摘要

目的

探讨胃癌（GC）患者血管侵犯（VI）与临床病理特征及预后的关系。

方法

回顾性分析2014年6月至2019年6月在海军军医大学第一附属医院胃肠外科接受根治性胃切除术的3600例GC患者，并根据特定的纳入和排除标准进行筛选。为减少VI影响导致的选择偏倚可能性，根据VI的有无将患者分为两组，并进行一对一倾向评分匹配（PSM），每组各724例患者。在对3205例GC患者的数据进行分析时，考察不同临床病理因素间VI阳性的组间差异。采用单因素和多因素Cox回归模型研究临床病理因素与预后的相关性。通过绘制Kaplan-Meier生存曲线进一步说明研究结果。

结果

本研究纳入3205例患者，其中989例（30.9%）为VI阳性，2216例（69.1%）为VI阴性。发现VI阳性组与年龄、体重指数（BMI）、pTNM分期、肿瘤位置、神经侵犯（PI）、Lauren分类和肿瘤沉积（TD）显著相关（P＜0.05），但与性别或基础疾病无关。VI阳性患者在PSM匹配前（P＜0.001）和匹配后（P = 0.007）的生存率均低于VI阴性患者。PSM后的Kaplan-Meier生存曲线表明，有VI的患者5年生存率为58.03%，而无VI的患者生存率更高，为66.25%。此外，匹配后的多因素分析表明，VI是预后的独立危险因素（P = 0.030）。