Subsite-specific metastatic organotropism and risk in gastric cancer: A population-based cohort study of the US SEER database and a Chinese single-institutional registry.
Subsite-specific metastatic organotropism and risk in gastric cancer: A population-based cohort study of the US SEER database and a Chinese single-institutional registry.
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关于胃癌（GC）的转移性器官性和风险是否因原发解剖部位而异的研究很少。本研究分别纳入来自监测、流行病学和最终结果（SEER）注册数据库和中国南方医院的15260例和1623例诊断为胃癌的患者。根据胃癌原发部位对患者进行分层，以不同脏器转移发生率确定各胃癌亚位点的转移器官倾向。最后，比较不同亚位点组间的转移性和风险。肝转移是贲门GC最常见的转移部位，而其他部位转移在身体、胃窦、重叠病变和未指明的GC中更为常见。肝脏和其他部位的转移也经常在眼底、幽门、小弧度和大弧度胃癌中观察到。将SEER和南方医院验证队列中确定原发肿瘤部位的GC患者按近端和远端GC分组进行比较，以便进一步分析。在SEER队列中，近端胃癌的前三个转移部位为肝脏（21.4%）、远端淋巴结（LN）（14.6%）和其他部位（主要是腹膜，11.9%），而远端胃癌的转移部位为其他部位（主要是腹膜，19.5%）、肝脏（11.8%）和远端淋巴结（9.5%）。在SEER组和南方组中，近端胃癌患者转移到肝脏、远端LN、肺和脑的发生率均显著高于远端胃癌患者（p < 0.05）。然而，在南方医院和SEER队列中，近端胃癌患者转移到其他部位/腹膜的比例明显低于远端胃癌患者（p < 0.05）。肝和远端LN是近端胃癌的首选转移部位，而腹膜转移在远端胃癌中更为常见。近端胃癌发生淋巴和血液转移的风险较高，而经体腔转移的风险较远端胃癌低。我们的研究结果强调了根据胃癌的主要亚位点对其进行分层的必要性，以帮助临床实践中与转移性管理相关的计划和决策。胃癌（GC）的转移性器官倾向和风险因原发解剖亚位点而异。肝脏和远处淋巴结是近端胃癌的首选转移部位，而腹膜转移在远端胃癌中更为常见。与远端胃癌相比，近端胃癌发生淋巴和血液转移的风险较高，而发生经结肠转移的风险较低。
Studies exploring whether metastatic organotropism and risk in gastric cancer (GC) differ by primary anatomical site are scarce. This study included 15,260 and 1623 patients diagnosed with GC from the Surveillance, Epidemiology, and End Results (SEER) registry database and the Nanfang Hospital in China, respectively. Patients were stratified according to primary site of GC, and the incidence of metastasis to different organs was used to determine the metastatic organotropism for each GC subsite. Finally, the metastatic organotropism and risk were compared among the different subsite groups. Liver metastasis was the most common metastasis site in cardia GC, whereas other‐site metastases were more common in the body, antrum, overlapping lesions, and unspecified GCs. Liver and other‐site metastases were also frequently observed in the fundus, pylorus, lesser curvature, and greater curvature GCs. Patients with GC with definite primary tumor sites in the SEER and validation Nanfang hospital cohorts were compared by grouping as proximal and distal GCs for further analysis. In the SEER cohort, the top three metastatic sites of proximal GC were liver (21.4%), distant lymph node (LN) (14.6%), and other‐site (mainly peritoneum, 11.9%), whereas those of distal GC were other‐site (mainly peritoneum, 19.5%), liver (11.8%), and distant LN (9.5%). The incidence of metastasis to the liver, distant LN, lung, and brain was significantly higher in patients with proximal GC than in those with distal GC in both the SEER and Nanfang cohorts (p < 0.05). However, metastasis to other‐site/peritoneum was significantly lower in patients with proximal GC compared to those with distal GC in the Nanfang Hospital and SEER cohorts, respectively (p < 0.05). Liver and distant LN are the preferred metastatic sites for proximal GC, whereas peritoneal metastasis is more common in distal GC. Proximal GC has a higher risk of lymphatic and hematogenous metastases, and a lower risk of transcoelomic metastasis than distal GC. Our findings highlight the need to stratify GC by its primary subsite to aid in planning and decision‐making related to metastatic management in clinical practice. Metastatic organotropism and risk vary by primary anatomical subsite in gastric cancer (GC). Liver and distant lymph nodes are the preferred metastatic sites for proximal GC, whereas peritoneal metastasis is more common in distal GC. Proximal GC has a higher risk of lymphatic and hematogenous metastases and a lower risk of transcoelomic metastasis, compared to distal GC.
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DOI：
10.1007/s10555-015-9586-9
发表时间：
2015-12
期刊：
Cancer metastasis reviews
影响因子：
--
作者：
Fidler IJ;Kripke ML
通讯作者：
Kripke ML
影响因子：
24.5
作者：
Camargo MC;Anderson WF;King JB;Correa P;Thomas CC;Rosenberg PS;Eheman CR;Rabkin CS
通讯作者：
Rabkin CS
影响因子：
3.7
作者：
Brouwer, Nelleke P. M.;Van der Kruijssen, Dave E. W.;de Wilt, Johannes H. W.
通讯作者：
de Wilt, Johannes H. W.
影响因子：
3.8
作者：
Beghelli, S;de Manzoni, G;Moore, PS
通讯作者：
Moore, PS
影响因子：
6.4
作者：
Thomassen, Irene;van Gestel, Yvette R.;de Hingh, Ignace H.
通讯作者：
de Hingh, Ignace H.