基于病理的胃纯印戒细胞癌与胃混合印戒细胞癌肿瘤生物学行为对比分析  

Comparative Analysis of Tumor Biological Behaviors Between Pure Gastric Signet-ring Cell Carcinoma and Mixed Gastric Signet-ring Cell Carcinoma Based on Pathology

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作  者:陈骄华 苏思标[2] CHEN Jiaohua;SU Sibiao(Guangxi Medical University,Nanning,530021;Department of Gastroenterology,the First Affiliated Hospital of Guangxi Medical University,Nanning)

机构地区:[1]广西医科大学,530021 [2]广西医科大学第一附属医院消化内科

出  处:《胃肠病学》2024年第6期325-333,共9页Chinese Journal of Gastroenterology

基  金:广西重点研发计划(桂科AB23026041)。

摘  要:背景:胃纯印戒细胞癌(pGSRC)和胃混合印戒细胞癌(mGSRC)的肿瘤生物学行为未得到深入研究,两者间的差异尚无定论。目的:比较pGSRC与mGSRC的肿瘤生物学行为,为胃癌的个体化、精准化治疗提供参考。方法:收集2012年12月—2023年6月在广西医科大学第一附属医院接受根治性手术切除的胃印戒细胞癌(GSRC)患者255例。比较pGSRC、mGSRC的肿瘤生物学行为;以Kaplan-Meier法进行生存分析,以单因素和多因素Cox比例风险模型分析影响GSRC以及pGSRC和mGSRC预后的因素。结果:与pGSRC相比,mGSRC更易发生脉管侵犯(37.3%对24.8%,P=0.034)和淋巴结转移(59.3%对42.9%,P=0.010),浸润深度为T1者(28.0%对45.7%,P=0.004)和TNM分期为Ⅰ期者(30.0%对51.4%,P=0.003)的比例明显降低。Kaplan-Meier生存分析显示,pGSRC患者的5年生存率显著高于mGSRC患者(90.4%对76.2%,P=0.003)。多因素Cox比例风险模型分析结果显示,性别(男性)、CA19-9、肿瘤直径、TNM分期(Ⅲ期)和病理类型(混合型)是GSRC患者根治术后预后不良的独立危险因素(P<0.05);饮酒史是pGSRC患者预后的独立危险因素(P<0.05);性别(男性)、CA19-9、肿瘤直径和TNM分期(Ⅲ期)是mGSRC预后的独立危险因素(P<0.05)。结论:与pGSRC相比,mGSRC表现出更具侵袭性的生物学行为,更易发生脉管侵犯和淋巴结转移,且TNM分期较晚、浸润深度相对较深、5年生存率相对较差,是术后预后不良的独立危险因素。Background:The tumor biological behaviors of pure gastric signet-ring cell carcinoma(pGSRC)and mixed gastric signet-ring cell carcinoma(mGSRC)have not been comprehensively investigated,and the differences between the two subtypes remain undetermined.Aims:To compare the tumor biological behaviors of pGSRC and mGSRC,in order to provide reference for the individualized and precise treatment of gastric cancer.Methods:A total of 255 patients with gastric signet-ring cell carcinoma(GSRC)who underwent radical surgical resection from December 2012 to June 2023 at the First Affiliated Hospital of Guangxi Medical University were enrolled.The tumor biological behaviors of pGSRC and mGSRC were compared.Survival analysis was performed using Kaplan-Meier method.Univariate and multivariate Cox proportional hazards model was used to identify prognostic factors for GSRC,as well as for pGSRC and mGSRC separately.Results:Compared with pGSRC,mGSRC was associated with significantly higher rates of vascular invasion(37.3%vs.24.8%,P=0.034)and lymph node metastasis(59.3%vs.42.9%,P=0.010),the proportions of patients with T1 infiltration depth(28.0%vs.45.7%,P=0.004)and TNM stageⅠ(30.0%vs.51.4%,P=0.003)were significantly decreased.Kaplan-Meier survival analysis showed that the 5-year survival rate of pGSRC patients was significantly higher than that of mGSRC patients(90.4%vs.76.2%,P=0.003).Multivariate Cox proportional hazards model analysis identified male gender,CA19-9,tumor diameter,TNM stageⅢ,and mixed pathological type as independent risk factors for poor prognosis in GSRC patients after radical surgery(P<0.05).Alcohol consumption history was an independent poor prognostic factor for pGSRC(P<0.05).Male gender,CA19-9,tumor diameter,and TNM stageⅢwere independent poor prognostic factors for mGSRC(P<0.05).Conclusions:Compared with pGSRC,mGSRC exhibits more aggressive biological behaviors.It is more likely to experience vascular invasion and lymph node metastasis,more advanced TNM stage,deeper infiltration depth and a relatively low

关 键 词:胃纯印戒细胞癌 胃混合印戒细胞癌 胃肿瘤 生物学行为 预后 

分 类 号:R73[医药卫生—肿瘤]

 

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