胃腺癌中肿瘤出芽与预后关系的研究

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   --本文经《美国外科病理学杂志》授权发布,其他媒体转载或引用须经《美国外科病理学杂志》同意,否则追究法律责任。
  摘要:肿瘤出芽与多种肿瘤的不良预后有关,但其在胃癌中的预后意义尚不明了。本研究旨在评价胃腺癌及其主要组织学类型中肿瘤出芽的预后意义。纳入本回顾性队列研究的583例病例均为1983~2016年在Oulu大学医院接受过手术治疗的胃腺癌病例。镜下观察计数原诊断用病理切片中每0.785mm2视野面积下肿瘤出芽的数量。根据肿瘤出芽数量将患者分为低出芽组(<10个)和高出芽组(≥10个)。分析肿瘤出芽与5年生存率以及总生存率的关系。采用Cox回归分析校正混杂因素评估95%可信区间(confidence intervals,CI)的风险比(hazard ratios,HR)。弥漫型胃癌由于其非黏附性生长模式难以确定肿瘤出芽情况。高出芽组患者5年生存率较低出芽组更低(校正HR,1.55;95%CI,1.20~2.01)。肠型腺癌高出芽组患者的5年生存率明显低于低出芽组(校正HR,1.57;95%CI,1.14~2.15)。而弥漫型腺癌不同肿瘤出芽组患者5年生存率无差异。总之,肿瘤高出芽是胃腺癌的一个独立预后因素,但仅限于肠型胃腺癌。弥漫型胃腺癌肿瘤出芽评判几乎不可行,且肿瘤出芽与预后没有相关性。
  关键词 :胃癌,肿瘤出芽,预后
  (Am J Surg Pathol 2019;43:229-234)
  美国外科病理学杂志中文版2019年第三期摘要NO.11
  ( 崔晋峰 翻译 张祥宏 审校 )






 
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