Poorly differentiated is more significant than signet ring cell component for lymph node metastasis in mixed-type early gastric cancer: a retrospective study from a large-volume hospital.
Poorly differentiated is more significant than signet ring cell component for lymph node metastasis in mixed-type early gastric cancer: a retrospective study from a large-volume hospital.
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DOI：
10.1007/s00464-020-07532-5
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Li XB
中科院分区：
文献类型：
--
作者：
Chen JN;Wang QW;Zhang QW;Tang ZR;Li XB
本研究的目的是探讨不同未分化成分在早期混合性胃癌淋巴结转移（LNM）中的作用。共有1596例接受胃切除术的EGC患者分为四种类型：纯分化型（PD）、纯低分化型（Poorly D）、纯印戒细胞癌（SRC）和混合型。混合型分为4个亚型：分化为主型与低分化成分混合型（MD-P）、低分化为主型与分化成分混合型（MP-D）、分化为主型与SRC成分混合型（MD-S）、低分化为主型与SRC成分混合型（MP-S）。我们分析了所有类型之间的临床病理学差异以及满足内镜粘膜下剥离术（ESD）标准的患者的 LNM 发生率。 LNM 在混合型 (21.9%) 中比在 PD (7.5%, P<0.001) 或 SRC (11.3%, P<0.001) 中更常见。当分析混合型亚组时，MD-P（15.4%）中 LNM 的发生率高于 PD（7.5%，P = 0.003）。 MD-S 中的 LNM（7.4%，P = 1.000）不高于 PD 中。 MP-S (24.5%) 的 LNM 发生率高于 SRC (11.3%, P < 0.001)，而不是 Poorly-D (22.7%, P = 0.681)。对于满足ESD标准的病变，MD-S（0%，P = 1.000）和MD-P（5.9%，P = 0.12）的LNM发生率并不高于PD（1.4%）。低分化成分的存在而非SRC增加了混合型的LNM率。建议采用 ESD 治疗符合 ESD 标准的 MD-S 和 MD-P。
The purpose of this study was to explore the role of different undifferentiated components in the lymph node metastasis (LNM) of early mixed gastric cancer. A total of 1596 patients with EGC who underwent gastrectomy were divided into four types: pure differentiated (PD), pure poorly differentiated (Poorly D), pure signet ring cell carcinoma (SRC), and mixed. Mixed type was classified into four subtypes: differentiated-predominant type mixed with poorly differentiated component (MD-P), poorly differentiated-predominant type mixed with differentiated component (MP-D), differentiated-predominant type mixed with SRC component (MD-S), and poorly differentiated-predominant type mixed with SRC component (MP-S). We analyzed the clinicopathological differences between all types and the rates of LNM of patients fulfilling endoscopic submucosal dissection (ESD) criteria. LNM was more common in mixed (21.9%) than in PD (7.5%, P < 0.001) or SRC (11.3%, P < 0.001). When analyzed the subgroups of mixed type, LNM was more frequent in MD-P (15.4%) than in PD (7.5%, P = 0.003). LNM in MD-S (7.4%, P = 1.000) was not higher than in PD. MP-S (24.5%) showed a higher rate of LNM than SRC (11.3%, P < 0.001) rather than Poorly-D (22.7%, P = 0.681). For lesions satisfying ESD criteria, MD-S (0%, P = 1.000), and MD-P (5.9%, P = 0.12) did not have higher rates of LNM than PD (1.4%). The presence of poorly differentiated component but not SRC increases the LNM rate of mixed type. ESD is recommended for the treatment of MD-S and MD-P consistent with ESD criteria.
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DOI：
10.1007/pl00011720
发表时间：
2000-12-01
期刊：
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
影响因子：
--
作者：
Gotoda, Takuji;Yanagisawa, Akio;Kato, Yo
通讯作者：
Kato, Yo
影响因子：
2.3
作者：
Lee, In Seob;Lee, Sol;Kim, Byung Sik
通讯作者：
Kim, Byung Sik
影响因子：
7.4
作者：
Takizawa, Kohei;Ono, Hiroyuki;Nakajima, Takashi
通讯作者：
Nakajima, Takashi
影响因子：
7.4
作者：
Min, Byung-Hoon;Kim, Kyoung-Mee;Kim, Jae J.
通讯作者：
Kim, Jae J.
影响因子：
6.2
作者：
Hyung, WJ;Noh, SH;Min, JS
通讯作者：
Min, JS