Setälä L P, Kosma V M, Marin S, Lipponen P K, Eskelinen M J, Syrjänen K J, Alhava E M
Department of Surgery, University Hospital of Kuopio, Finland.
Br J Cancer. 1996 Sep;74(5):766-72. doi: 10.1038/bjc.1996.434.
A retrospective analysis of 321 gastric cancer patients was made to assess the prognostic value of TNM classification, tumour differentiation, Laurén classification, proliferative rate, inflammatory reaction and tumour invasion in vascular or neural structures of the gastric wall. The TNM classification showed the strongest correlation with survival in univariate and multivariate analyses (P < 0.0001). The invasion in lymphatic or vascular system and Laurén classification were also independent prognosticators in multivariate analysis (P < 0.05). In univariate analysis, the WHO-grade, the size and the location of the tumour and perinueral invasion were significant prognostic factors (P < 0.01), as were the infiltration of lymphocytes and plasma cells in the tumour (P < 0.05). On the other hand, the mitotic indices reflecting the proliferative activity of the tumour cells showed no significant correlation with the prognosis. The results indicate that the prognostic power of the TNM classification can be further increased by assessment of the above special histological features in gastric cancer.
对321例胃癌患者进行回顾性分析，以评估TNM分类、肿瘤分化、劳伦分类、增殖率、炎症反应以及肿瘤侵犯胃壁血管或神经结构的预后价值。在单因素和多因素分析中，TNM分类与生存率的相关性最强（P < 0.0001）。在多因素分析中，淋巴管或血管系统侵犯以及劳伦分类也是独立的预后因素（P < 0.05）。在单因素分析中，WHO分级、肿瘤大小和位置以及神经周围侵犯是显著的预后因素（P < 0.01），肿瘤中淋巴细胞和浆细胞浸润也是如此（P < 0.05）。另一方面，反映肿瘤细胞增殖活性的有丝分裂指数与预后无显著相关性。结果表明，通过评估上述胃癌特殊组织学特征，TNM分类的预后能力可进一步提高。
