解放军医学杂志2024，Vol.49Issue(7)：747-753,7.DOI:10.11855/j.issn.0577-7402.2283.2023.0529
不同病理亚型胃印戒细胞癌的临床预后分析
Clinical prognosis analysis of gastric signet ring cell carcinoma with different pathological subtypes
摘要
Abstract
Objective To explore the clinicopathological characteristics,prognosis and influencing factors of different pathological subtypes of gastric signet ring cell carcinoma(GSRC).Methods A retrospective analysis was performed on the clinical data of 232 patients with GSRC collected from January 2016 to December 2018 in Lanzhou University Second Hospital.According to the WHO classification criteria for GSRC,the patients were divided into pure gastric signet-ring cell carcinoma(pGSRC,n=36)and mixed gastric signet-ring cell carcinoma(mGSRC,n=196).The follow-up as of September 30,2022,the survival analysis was done using Kaplan-Meier method,the univariate and multivariate Cox regression were performed to analyze the risk factors affecting the prognosis of GSRC patients.Results The median survival time of pGSRC and mGSRC patients was 41.0(6.0-70.0)months and 24.0(2.0-74.0)months,respectively.Kaplan-Meier analysis showed that combination with diabetes,anemia,tumor diameter,nerve invasion,lymphovascular invasion,T stage,N stage,GSRC pathological subtype,CA125 and tumor diameter could affect the overall survival(OS)of patients with GSRC after radical gastrectomy(P＜0.05),but Her-2,whether adjuvant chemotherapy or not and others elements had no significant effect on OS of GSRC patients after radical gastrectomy(P＞0.05).Univariate Cox regression analysis showed that the combination with diabetes(P=0.031),anemia(P=0.028),tumor diameter＞5 cm(P=0.009),nerve invasion(P=0.002),lymphovascular invasion(P=0.002),mGSRC pathological type(P=0.039),T2-T4 stage(P=0.001),N1-N4 stage(P=0.004),pTNM stage Ⅲ(P=0.044),the number of lymph node metastasis＞30(P=0.044)and CA125 positive(P=0.009)were related to the prognosis of patients with GSRC after radical gastrectomy.Multivariate Cox regression analysis showed that mGSRC pathological type(P=0.035),T2-T4 stage(P=0.003),CA125 positive(P=0.010)were independent risk factors for poor prognosis of patients with GSRC after radical gastrectomy.Conclusion Compared with pGSRC,patients with mGSRC at diagnosis have higher pTNM stages,more aggressive,and shorter median survival time.mGSRC pathological type,T2-T4 stage,and CA125 positive were all independent factors affecting the prognosis of patients with GSRC.关键词
印戒细胞癌/胃纯印戒细胞癌/胃混合印戒细胞癌/预后Key words
signet ring cell carcinoma/pure gastric signet-ring cell carcinoma/mixed gastric signet-ring cell carcinoma/prognosis分类
医药卫生引用本文复制引用
沈亦敏,李元元,王舟,徐伟,李金洲,穆彦熹,姚亚龙,汪文杰,陈晓..不同病理亚型胃印戒细胞癌的临床预后分析[J].解放军医学杂志,2024,49(7):747-753,7.基金项目
This work was supported by the Gansu Provincial Youth Science and Technology Fund(21JR7RA424) 甘肃省青年科技基金项目(21JR7RA424) （21JR7RA424）
