T1期胃印戒细胞癌的临床病理学特征  

Clinicopathologic characteristics of signet ring cell carcinoma in T1 gastric cancer

作　　者：陈健[1] 任刚[1] 蔡嵘[2] 赵建溪 郭辰[1] 李华莉[1] 

机构地区：[1]上海交通大学医学院附属新华医院放射科,上海200092 [2]上海交通大学医学院附属瑞金医院放疗科,上海200025

出　　处：《临床荟萃》2016年第2期207-210,共4页Clinical Focus

基　　金：上海交通大学医学院科研基金(09XJ21013);上海市卫生局科研基金(2010029,2010057);上海市科委科研基金(124119a0300);上海市教委科研基金(12Y2034)

摘　　要：目的探讨早期胃印戒细胞癌(SRC)的临床与病理特点,及与其他组织学类型的早期胃癌的鉴别。方法回顾性分析255例经手术病理或内镜活检证实的T1期胃癌患者(其中27例SRC)的临床及病理资料。结果T1期胃癌中,SRC的平均年龄为(50.7±2.2)岁,明显低于管状腺癌(60.6±1.0)岁及低分化腺癌(57.3±1.4)岁(P<0.01)。SRC女性患者的比例为51.8%,明显高于管状腺癌(26.2%)(P<0.01),与低分化腺癌(50.6%)相近。早期SRC好发于胃中部(63.0%),内镜下以凹陷型(77.8%)多见。SRC组T1a患者的比例为77.8%,高于低分化腺癌组(56.3%)及管状腺癌组(61.0%),3组差异无统计学意义(P>0.05)。T1期伴有淋巴结转移的SRC患者的比例(18.5%),高于管状腺癌组(12.1%),与低分化腺癌组(17.2%)相仿(P>0.05)。SRC组病灶的最大径与低分化腺癌组及管状腺癌组差异无统计学意义(P>0.05)。SRC组T1a期患者的淋巴结转移率(15.0%)与T1b期(28.6%)差异无统计学意义(P>0.05)。结论早期SRC具有一定的临床病理特征,有助于指导临床治疗及判断预后。Objective To analyze clinicopathologic characteristics of early signet ring cell carcinoma（SRC）,and to differentiate the tumor with other histologic types in T1 gastric cancer.Methods A retrospective analysis was undertaken for 255 patients with early gastric cancer who had experienced curative gastrectomy or endoscopic biopsy.Among them,27 patients had SRC.Results The patients with early SRC（50.7±2.2）y was much younger than the T1 gastric cancer of the poorly differentiated adenocarcinoma（57.3±1.42） y and tubular adenocarcinoma（60.6±1.0）y（P 〈0.01）.Patients with early gastric SRC had a greater proportion of females than other histologic types（P 〈0.01）.63.0% of early gastric cancer（EGC）lesions in SRC located in the middle third of the stomach,and 77.8%macroscopic types of EGC in SRC were depressed.77.8% of SRC lesions were limited within the mucosal layer,which were more than poorly differentiated adenocarcinoma（56.3%）and tubular adenocarcinoma（61.0%）.Early SRC had a similar rate of lymph node metastasis（18.5%） to poorly differentiated adenocarcinoma（17.2%）,and a higher rate than tubular adenocarcinoma（12.1%）,but there were no statistically significant differences（P 〉0.05）.There were no significant difference of tumor size among early SRC,poorly differentiated adenocarcinoma and tubular adenocarcinoma（P 〉0.05）.In early SRC,there was no significance difference in lymph node metastasis according to depth of invasion（P〉0.05）.Conclusion In early gastric cancer,SRC is a distinct type of gastric carcinoma in terms of clinicopathologic characteristics,which may have some value in the treatment strategy and prognosis assessment.

关 键 词：胃肿瘤 癌 印戒细胞 病理学 临床 

分 类 号：R735.2[医药卫生—肿瘤]