Prognostic Stratification of Advanced Gastric Signet Ring Cell Carcinoma by Clinicopathological Factors and GALNT14 Genotype.
Prognostic Stratification of Advanced Gastric Signet Ring Cell Carcinoma by Clinicopathological Factors and GALNT14 Genotype.
复制标题
DOI：
10.7150/jca.26293
复制
发表时间：
2018
影响因子：
3.9
通讯作者：
Yeh CT
中科院分区：
文献类型：
--
作者：
Chen TH;Lin WR;Lee C;Chiu CT;Hsu JT;Yeh TS;Lin KH;Le PH;Yeh CT
背景：胃印戒细胞癌（SRCC）是一种以胞浆内大量粘蛋白为特征的组织学变异型癌。虽然人们已经认识到具有这种特征的胃腺癌预后较差，但胃SRCC本身的预后分层尚未明确定义。N-乙酰氨基半乳糖转移酶14（GALNT 14）基因型与粘液型结直肠癌的治疗效果较差相关。在此，我们结合临床病理因素和GALNT 14基因型对进展期胃SRCC的预后进行分层。方法：回顾性分析347例胃癌患者的GALNT 14基因分型。临床病理因素包括预后分层。结果：347例患者中，341例行根治性胃切除术，6例行姑息性胃切除术。总生存期的Kaplan-Meier分析表明，肿瘤-淋巴结-转移分期只能将患者分为三个预后可区分的组：第1组（IA期）;第2组（IB/IIA期）和第3组（其余肿瘤-淋巴结-转移分期合并）。第3组患者的多变量Cox比例风险模型显示GALNT 14“TT”基因型（P = 0.0482）。肿瘤大小（P = 0.0009），节点状态（P <0.0001），转移情况（P = 0.0096），和神经周围浸润探索性亚组分析显示，GALNT 14“TT”基因型与具有更侵袭性表型的SRC中的不利OS相关：淋巴管浸润（P = 0.021）、血管浸润（P = 0.0076）和神经周围浸润（P = 0.0161）。因此，建立了一个评分系统，能够将晚期胃SRCC患者分为三个可区分的预后亚组。结论：结合临床病理因素和GALNT 14基因型可将胃SRCC分为不同的预后亚组。
Background: Gastric signet ring cell carcinoma (SRCC) is a histologic variant characterized by abundant intracytoplasmic mucin. Although it has been recognized that gastric adenocarcinoma harboring this feature has poorer prognosis, prognostic stratification within gastric SRCCs themselves has not been clearly defined. N-acetylgalactosaminyltransferase14 (GALNT14) genotype has been associated to poorer treatment outcome in mucinous type colorectal cancer. Here we incorporated clinicopathological factors and GALNT14 genotype to stratify prognosis of advanced gastric SRCC. Methods: Totally 347 gastric SRCC patients were retrospectively enrolled for GALNT14 genotyping. Clinicopathological factors were included for prognosis stratification. Results: Of the 347 patients, 341 underwent radical-intent gastrectomy and 6 received palliative gastrectomy. Kaplan-Meier analysis for overall survival indicated that Tumor-Node-Metastasis staging could only stratify the patients into three prognosis-distinguishable groups: group-1 (stage IA); group-2 (stage IB/IIA) and group-3 (the remaining Tumor-Node-Metastasis stages combined). Multivariate Cox-proportional hazard models for group-3 patients revealed GALNT14 “TT” genotype (P = 0.0482). Tumor size (P = 0.0009), node status (P <0.0001), metastasis status (P = 0.0096), and perineural invasion (P = 0.037) independently associated with unfavorable OS. Exploratory subgroup analysis showed that GALNT14”TT” genotype was associated with unfavorable OS in SRCCs with more aggressive phenotypes: node status >0 (P = 0.0013), lymphatic invasion (P = 0.021), vascular invasion (P = 0.0076) and perineural invasion (P = 0.0161). Accordingly, a scoring system was established capable of stratifying advanced gastric SRCC patients into three distinguishable prognostic subgroups. Conclusions: Gastric SRCC could be stratified into different prognostic subgroups by combining clinicopathological factors and GALNT14 genotype.
登录
查看更多内容
影响因子：
9.6
作者：
Kunisaki, C;Shimada, H;Akiyama, H
通讯作者：
Akiyama, H
影响因子：
6.2
作者：
Hyung, WJ;Noh, SH;Min, JS
通讯作者：
Min, JS
影响因子：
1.7
作者：
Kim, DY;Park, YK;Lee, JH
通讯作者：
Lee, JH
影响因子：
--
作者：
De Mariano M;Gallesio R;Chierici M;Furlanello C;Conte M;Garaventa A;Croce M;Ferrini S;Tonini GP;Longo L
通讯作者：
Longo L
影响因子：
2.5
作者：
Huh, Cheal Wung;Jung, Da Hyun;Noh, Sung Hoon
通讯作者：
Noh, Sung Hoon