胃印戒细胞癌的临床病理特点和预后分析  

Clinicopathological features and prognostic analysis of patients with signet ring cell gastric carcinoma

作　　者：崔景利 梁寒[1] 邓靖宇[1] 丁学伟[1] 王晓娜[1] 张李[1] 梁月祥[1] 蒋楠[1] 

机构地区：[1]天津医科大学肿瘤医院,胃部肿瘤科国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,300060

出　　处：《中华肿瘤杂志》2015年第5期367-370,共4页Chinese Journal of Oncology

基　　金：国家重点研究发展计划973计划（2010CB529301）;天津市科技计划项目（12ZCDZSY16400）

摘　　要：目的比较胃印戒细胞癌与非印戒细胞癌的临床病理特点，探讨影响胃印戒细胞癌患者预后的因素。方法回顾性分析1447例胃癌手术患者的临床资料，比较胃印戒细胞癌和非印戒细胞癌患者的临床病理特点及预后。结果胃印戒细胞癌与非印戒细胞癌患者在年龄、性别、肿瘤部位、T分期、N分期、远处转移、TNM分期和手术方式间的差异均有统计学意义（均P〈0．05）。胃印戒细胞癌和非印戒细胞癌患者的5年生存率分别为29．6％和42．9％，差异有统计学意义（P〈0．05）。I、Ⅱ、Ⅲ和Ⅳ期胃印戒细胞癌患者的5年生存率分别为71．0％、45．6％、16．9％和6．0％，I、Ⅱ、Ⅲ和Ⅳ期胃非印戒细胞癌患者分别为79．3％、58．3％、29．2％和11．9％，其中Ⅲ、Ⅳ期胃印戒细胞癌患者与Ⅲ、Ⅳ期胃非印戒细胞癌患者的5年生存率差异有统计学意义（P〈0．05）。多因素分析显示，肿瘤大小、T分期和N分期为胃印戒细胞癌患者的独立预后因素。结论胃印戒细胞癌具有独特的临床病理特点，预后较差。早期发现、早期治疗可提高胃印戒细胞癌患者的预后。Objective To compare the clinicopathological features of signet ring cell gastric carcinoma （SRCC） with those of non-signet ring cell cancers and explore the prognostic factors of signet ring cell gastric carcinoma. Methods We retrospectively reviewed the medical records of 1447 gastric cancer patients, including gastric signet ring cell and non-signet ring cell cancers. Their clinicopathological characteristics and overall survival data were analyzed. Results The differences in the age, sex, tumor location, depth of invasion, lymph node metastasis, distant metastasis, TNM classification and surgical type were significant between gastric signet ring cell and non-signet ring cell gastric carcinomas. The 5-year survival rate of the patients with gastric signet ring cell carcinoma was 29.6%, while that of the non-signet ring cell cancers was 42.9% （P〈0.05）. The 5-year survival rate for each stage of gastric signet ring cell carcinoma and non-signet ring cell cancers was 71.0% and 79.3% for stage I , 45.6% and 58.3% for stage Ⅱ , 16.9% and 29.2% for stage Ⅲ ,and 6.0% and 11.9% for stage IV cases, respectively, with a significant difference only between stages Ⅲ and IV cancers （P〈 0.05 ）. Multivariate analysis showed that tumor diameter, T stage and N stage were independent prognostic factors for signet ring cell gastric carcinoma. Conclusions The signet ring cell gastric carcinoma has unique clinicopathological features compared with non-signet ring cell carcinoma. Early detection and treatment can improve the prognosis for patients with gastric signet ring cell carcinoma.

关 键 词：胃肿瘤 癌 印戒细胞 病理学 临床 预后 

分 类 号：R735.2[医药卫生—肿瘤]