Rugge M, Sonego F, Panozzo M, Baffa R, Rubio J, Farinati F, Nitti D, Ninfo V, Ming S C
Department of Pathology, Istituto Scientifico per lo Studio e la Cura dei Tumori, Genova, Italy.
Cancer. 1994 Feb 15;73(4):1127-33. doi: 10.1002/1097-0142(19940215)73:4<1127::aid-cncr2820730402>3.0.co;2-q.
The prognostic relevance of morphology in advanced gastric cancer is well known. Data on tumor cell DNA content are still inadequate and contradictory.
Morphologic parameters and DNA ploidy were evaluated in 76 gastric cancer patients with no extranodal metastases (Stage I, 10 cases; Stage II, 20 cases; and Stage III, 46 cases), using formalin-fixed paraffin-embedded tissue. All cases were followed for at least 6 years after surgery or until death.
Among the potential prognostic factors analyzed by Mantel-Cox and generalized Wilcoxon statistics, male sex (P = 0.02), cardiac location of neoplasia (P = 0.02), deeper infiltration of the gastric wall (P = 0.001), vascular neoplastic invasion (P = 0.006), metastatic lymph nodes (P = 0.001), pathologic stage (P = 0.0001), and aneuploidy (P = 0.01) were significantly associated with lower survival rate. Testing of all of the above-mentioned variables by the Cox stepwise multiple regression model disclosed that factors independently associated with survival were stage (P = 0.0001), ploidy (P = 0.0006), and vascular carcinomatous invasion (P = 0.01).
In gastric cancer with no extranodal metastases, DNA ploidy was found to be the most significant prognostic parameter after pathologic stage.
晚期胃癌形态学的预后相关性已广为人知。关于肿瘤细胞DNA含量的数据仍然不足且相互矛盾。
使用福尔马林固定石蜡包埋组织，对76例无淋巴结外转移的胃癌患者（I期10例、II期20例、III期46例）的形态学参数和DNA倍体进行评估。所有病例术后随访至少6年或直至死亡。
通过Mantel-Cox和广义Wilcoxon统计分析的潜在预后因素中，男性（P = 0.02）、肿瘤位于贲门部（P = 0.02）、胃壁浸润较深（P = 0.001）、肿瘤血管侵犯（P = 0.006）、转移淋巴结（P = 0.001）、病理分期（P = 0.0001）和非整倍体（P = 0.01）与较低生存率显著相关。通过Cox逐步多元回归模型对上述所有变量进行检验发现，与生存独立相关的因素为分期（P = 0.0001）、倍体（P = 0.0006）和癌组织血管侵犯（P = 0.01）。
在无淋巴结外转移的胃癌中，发现DNA倍体是继病理分期后最显著的预后参数。
