肿瘤出芽作为预测老年患者胃癌根治术后远处器官转移标志物的临床意义探讨  

Clinical significance of tumor budding as a marker for predicting distant metastasis after radical gastrectomy in elderly patients

作　　者：接玉 王佩 姚林 孙艺萌 徐炜[1] 邱悦 姜大鹏[1] 王晓燕 范钰[1] Jie Yu;Wang Pei;Yao Lin;Sun Yimeng;Xu Wei;Qiu Yue;Jiang Dapeng;Wang Xiaoyan;Fan Yu(Cancer Institute,The Affiliated People's Hospital of Jiangsu University,Zhenjiang 212002,China;Department of Gastroenterology,Suqian First People's Hospital,Suqian 223899,China)

机构地区：[1]江苏大学附属人民医院肿瘤研究所,镇江212002 [2]宿迁市第一人民医院消化内科,宿迁223899

出　　处：《中华老年医学杂志》2024年第3期311-316,共6页Chinese Journal of Geriatrics

基　　金：江苏省卫生健康委员会重点项目基金(ZD2022052);江苏省重大临床专项基金(BE2015666);镇江市社会发展基金(SH2022032、SH2022090);宿迁市科技工程基金(S2022)。

摘　　要：目的探讨老年患者胃癌根治术后远处器官转移指标的临床意义。方法回顾性分析2015年3月至2022年6月收治的124例行胃癌根治术后发生转移老年患者的临床病理资料,分析影响患者术后远处转移的临床病理因素。采用苏木精-伊红染色法进行胃癌组织肿瘤出芽的评估,并分析其临床意义。结果胃癌组织肿瘤出芽与脉管侵犯(χ^(2)=6.731,P=0.009)、淋巴结转移数目(rs=0.481,P<0.001)、术后远处转移时间(rs=-0.450,P<0.001)明显相关。单因素分析结果显示,肿瘤出芽分级、肿瘤大小、脉管侵犯、术后化疗、癌结节、术前血清糖类抗原125、淋巴结转移数目是老年患者胃癌根治术后无远处转移生存期的影响因素(均P<0.05);多因素分析结果显示,老年胃癌患者肿瘤出芽分级是术后远处转移重要的独立预后因素之一(HR=3.731,P<0.001)。结论肿瘤出芽可以作为预测老年患者胃癌根治术后远处器官转移的标志物,具有重要的临床意义。Objective To investigate the clinical significance of tumor budding as an indicator of postoperative distant organ metastasis after radical gastrectomy in elderly patients diagnosed with gastric cancer.Methods The clinical and pathological data of 124 elderly patients who experienced metastasis after undergoing radical gastrectomy were retrospectively analyzed.The analysis was conducted from March 2015 to June 2022,focusing on the clinicopathological factors that influenced the occurrence of postoperative distant metastasis in these patients.Tumor budding in gastric cancer tissues was assessed using hematoxylin-eosin staining,and its clinical significance was analyzed.Results The tumor budding grade of gastric cancer tissues showed a significant correlation with vascular invasion(χ^(2)=6.731,P=0.009),the number of lymph node metastases(rs=0.481,P<0.001),and the time of distant metastasis(rs=-0.450,P<0.001).In the univariate analysis,factors such as tumor budding grade,tumor size,vascular invasion,postoperative chemotherapy,cancerous nodule,preoperative serum carbohydrate antigen 125,and the number of lymph node metastases were found to influence distant metastasis-free survival after radical gastrectomy in elderly patients(all P<0.05).The multifactorial analysis also indicated that tumour outgrowth grade was an important independent prognostic factor for postoperative distant metastasis in elderly gastric cancer patients(HR=3.731,P<0.001).Conclusions The findings of this study indicate that tumor budding may serve as a potential marker for predicting distant organ metastasis in elderly patients who have undergone radical gastrectomy.This discovery holds significant clinical implications.

关 键 词：胃肿瘤 肿瘤转移 肿瘤标记 生物学 肿瘤出芽 

分 类 号：R735.2[医药卫生—肿瘤]