Clinical significance of lymphatic invasion in the esophageal region in patients with adenocarcinoma of the esophagogastric junction
Clinical significance of lymphatic invasion in the esophageal region in patients with adenocarcinoma of the esophagogastric junction
复制标题
食管胃结合部腺癌食管区淋巴管侵犯的临床意义
DOI：
10.1002/jso.25964
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发表时间：
2020
影响因子：
2.5
通讯作者：
Nagino Masato
中科院分区：
文献类型：
--
作者：
Sugita Shizuki;Kuwata Takeshi;Tokunaga Masanori;Kaito Akio;Watanabe Masahiro;Tonouchi Akiko;Kinoshita Takahiro;Nagino Masato
背景与目的食管胃交界周围的淋巴流动较为复杂。因此，尚不清楚食管胃交界腺癌（AEG）患者食管区（eLI）和胃区（gLI）的淋巴浸润是否同样影响淋巴结转移（LNM）的发生率，从而影响生存。方法回顾性分析2008年1月至2017年7月175例AEG患者的临床病理资料。研究了LNM的危险因素以及eLI或gLI对生存结果的影响。结果34%的患者（59/175）检出seli。通过多因素分析，eLI与纵隔LNM（比值比[OR] = 2.98, 95%可信区间[CI]: 1.26 ~ 7.05）和腹部LNM （OR = 5.44, 95% CI: 1.95 ~ 15.20）的风险增加相关。eLI患者的5年总生存率（53%）明显低于无eLI患者（76%）（风险比= 2.45,95% CI: 1.37‐10.01）。gLI在这两种分析中都没有被选择。结论与gLI相比，eLI阳性与AEG患者纵隔和腹部淋巴结转移密切相关，且生存期较差。在组织病理学检查中，单独评估eLI和gLI似乎是有意义的。
Background and ObjectivesThe lymphatic flow around the esophagogastric junction is complicated. Therefore, it is unclear whether lymphatic invasion in the esophageal region (eLI) and in the gastric region (gLI) in patients with adenocarcinoma of the esophagogastric junction (AEG) equally affect the incidence of lymph node metastases (LNM), and consequently, survival.MethodsWe retrospectively reviewed clinicopathological data of 175 patients with AEG between January 2008 and July 2017. Risk factors for LNM and impacts of eLI or gLI on survival outcomes were investigated.ResultseLI was identified in 34% of the patients (59/175). By multivariate analysis, eLI was associated with an increased risk of both mediastinal LNM (odds ratio [OR] = 2.98, 95% confidence interval [CI]: 1.26‐7.05) and abdominal LNM (OR = 5.44, 95% CI: 1.95‐15.20). The 5‐year overall survival for patients with eLI (53%) was significantly worse than for patients without eLI (76%) (hazard ratio = 2.45, 95% CI: 1.37‐10.01). gLI was not selected in either of these analyses.ConclusionsPositive eLI was strongly associated with mediastinal and abdominal LNM and worse survival in patients with AEG compared with gLI. In the histopathological examination, it seems to make sense to assess eLI and gLI separately.
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影响因子：
3.7
作者：
Liang, Pin;Nakada, Ichiro;Tabuchi, Takafumi
通讯作者：
Tabuchi, Takafumi
影响因子：
4.6
作者：
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影响因子：
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作者：
Kikuchi, Eiji;Margulis, Vitaly;Shariat, Shahrokh F.
通讯作者：
Shariat, Shahrokh F.
回应评论：食管胃交界处肿瘤淋巴结转移图谱。
影响因子：
9
作者：
Y. Kurokawa;Y. Doki;H. Takeuchi;Y. Kitagawa
通讯作者：
Y. Kitagawa
影响因子：
3.8
作者：
Kunisaki, Chikara;Makino, Hirochika;Takahashi, Masazumiu
通讯作者：
Takahashi, Masazumiu