Therapeutic strategy for signet ring cell carcinoma of the stomach
Therapeutic strategy for signet ring cell carcinoma of the stomach
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DOI：
10.1002/bjs.4637
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发表时间：
2004-10-01
影响因子：
9.6
通讯作者：
Akiyama, H
中科院分区：
文献类型：
--
作者：
Kunisaki, C;Shimada, H;Akiyama, H
背景资料：胃印戒细胞癌（SRC）患者的临床病理特征和预后的报告是相互矛盾的。方法：回顾性分析了1450例胃癌患者进行了胃切除术。在1113例接受根治性胃切除术的患者中，174例为SRC（早期，120例;晚期，54例），939例为其他类型的胃癌。SRC和非SRC患者的临床病理特征，预后因素和手术结果进行了比较。结果：在早期胃癌患者中，年龄，组织学类型，淋巴结转移的数量和解剖范围独立影响预后。SRC患者的生存率明显高于非SRC患者，尽管淋巴结转移的范围或数量没有差异。直径小于等于40圈的粘膜层肿瘤和直径小于等于20圈的粘膜下病变与淋巴结转移无关。SRC在先进的疾病往往是低分化或硬结，但宏观外观不是一个独立的预后factor.Conclusion：早期SRC的胃是一个更好的预后比非SRC。相反，在进展期胃癌中，组织学类型不能用于建立确定的治疗策略。
Background: Reports of clinicopathological characteristics and prognosis in patients with signet ring cell carcinoma (SRC) of the stomach are conflicting.Methods: A retrospective review was undertaken of 1450 patients with gastric cancer who had undergone gastrectomy. Of 1113 patients who underwent a curative gastrectomy, 174 had SRC (early, 120; advanced, 54) and 939 had other types of gastric carcinoma. Clinicopathological features, prognostic factors and surgical outcome in patients with SRC and non-SRC were compared.Results: In patients with early gastric cancer, age, histological type, and number and anatomical extent of lymph node metastases independently affected prognosis. Patients with SRC had a significantly better survival rate than those with non-SRC, although there was no difference in the extent or number of lymph node metastases. Mucosal tumours with a diameter of 40 turn or less and submucosal lesions with a diameter of 20 turn or less were not associated with lymph node metastasis. SRC in advanced disease was frequently poorly differentiated or scirrhous, but macroscopic appearance was not an independent prognostic factor.Conclusion: Early SRC of the stomach is associated with a better prognosis than non-SRC. Conversely, in advanced gastric cancer histological type cannot be used to establish a definitive therapeutic strategy.