早期胃混合型印戒细胞癌的临床病理因素分析  

The clinicopathologic factors analysis of early mixed signet ring cell in gastric carcinoma

作　　者：徐俊[1] 张恩勇[2] 罗天航[1] 薛绪潮 崔航天 方国恩[1] 

机构地区：[1]第二军医大学附属长海医院,第二军医大学普外一科,上海200433 [2]中国人民解放军第一一八医院外科

出　　处：《实用肿瘤学杂志》2016年第5期414-419,共6页Practical Oncology Journal

摘　　要：目的回顾性研究印戒细胞比例低于50%的早期胃癌,分析其临床病理学特征和术后生存率。方法于2008年1月-2010年1月共计424例患者在第二军医大学附属长海医院诊断为早期胃癌,根据肿瘤细胞内印戒细胞癌的比例不同,将其分为三组:印戒细胞癌(肿瘤细胞中印戒细胞比例>50%,SRC组)、混合型印戒细胞癌(肿瘤细胞中印戒细胞成分<50%,Mixed-SRC组)和非印戒细胞癌(肿瘤细胞中无印戒细胞成分,Non-SRC组)。评价术后临床病理学指标和预后,并研究其与病理类型的关系。结果在早期胃癌中,混合型印戒细胞癌组在发病年龄和性别上与印戒细胞癌组相似,较其他组更易侵犯至黏膜下层且淋巴结转移率更高(P<0.05),五年生存率更低(P<O.05),免疫组化指标与其他两组并无统计学差异。在多因素分析中,混合型印戒细胞癌是影响淋巴结转移的独立危险因素。结论在早期胃癌中,混合型印戒细胞癌易出现淋巴结转移,其生物学行为较其他两组更具侵袭性,预后也更差。Objective To analyze the clinic pathologic factors and survival rate by performing a retro-spective study on the early gastric carcinoma （EGC）with signet ring cell underwent curative gastrostomy （SRC） percentage less than 50%after operation .Methods A total of 424 patients was diagnosed as EGC from January 2008 to January 2010 in Changhai Hospital .The patients were divided into three groups according to the different percentage of SRC within tumor cells , SRC group （ with percentage of SCR more than 50%） , Mixed SRC group （with percentage of SRC less than 50%）,and Non-SRC group（Classic adenocarcinoma without SRC ）.Then we evaluated the clinic pathologic indicators and prognoses , and study on the relationship with histologic types . Results In ECG,the mixed-SRC group was similar to the SRC group on the phases of onset age and sex .On the other phases,the mixed-SRC group was more associated with mucosa -confined,lower lymph node metasta-sis（LNM）,and 5-year survival rate was better than adenocarcinoma group （P〈0.05）.However,the mixed-SRC group showed more submucosal invasion ,and higher LNM than other groups （ P〈0 .05 ） .The mixed-SRC component was one of the independent risk factors of LNM .Conclusion In EGC,mixed-SRC had a more favor-able risk factor of LNM ,showed more aggressive behavior than other groups and displayed poor prognosis .

关 键 词：临床病理学特征 早期胃癌 印戒细胞癌 

分 类 号：R735.2[医药卫生—肿瘤]