CAJ | 학술논문

背景与目的:胃是人体重要的具有神经内分泌功能的器官之一,部分胃癌在发生、发展过程中伴随着神经内分泌细胞分化(neuroendocrine cell differentiation,NED)现象,NED对胃癌患者预后的影响还存在争议.本研究旨在探讨胃癌伴NED的临床病理特点、治疗及预后.方法:回顾性分析复旦大学附属肿瘤医院胃及软组织外科2001年3月—2009年7月收治的17例胃癌伴NED患者和具有相同分期的34例不伴NED胃癌患者的临床资料,比较两组患者的临床病理特征和预后差异.结果:肿瘤的发生部位和分化程度与胃癌是否伴有NED具有明显相关性.伴NED的胃癌患者的1年和3年生存率明显低于不伴NED的胃癌患者的1年和3年生存率(71% vs 79%,38%vs 47%,χ2=4.212,P=0.040).多因素分析结果显示,患者年龄、浸润深度及远处转移是独立的预后因素.结论:免疫组织化学染色对伴NED胃癌的确诊具有重要价值,伴有NED可能是胃癌预后不良的重要因素之一.
배경여목적:위시인체중요적구유신경내분비공능적기관지일,부분위암재발생、발전과정중반수착신경내분비세포분화(neuroendocrine cell differentiation,NED)현상,NED대위암환자예후적영향환존재쟁의.본연구지재탐토위암반NED적림상병리특점、치료급예후.방법:회고성분석복단대학부속종류의원위급연조직외과2001년3월—2009년7월수치적17례위암반NED환자화구유상동분기적34례불반NED위암환자적림상자료,비교량조환자적림상병리특정화예후차이.결과:종류적발생부위화분화정도여위암시부반유NED구유명현상관성.반NED적위암환자적1년화3년생존솔명현저우불반NED적위암환자적1년화3년생존솔(71% vs 79%,38%vs 47%,χ2=4.212,P=0.040).다인소분석결과현시,환자년령、침윤심도급원처전이시독립적예후인소.결론:면역조직화학염색대반NED위암적학진구유중요개치,반유NED가능시위암예후불량적중요인소지일.
Background and purpose:Stomach plays an important role in neuroendocrine function, therefore some cases of gastric cancer couple with neuroendocrine cell differentiation (NED). The prognostic significance of NED in gastric cancer patients is still in controversy. The aim of this study was to investigate the clinicopathological features, treatment, and prognosis of gastric cancer with NED. Methods:From Mar. 2001 to Jul. 2009, 17 gastric cancer patients with NED and 34 without NED having the same stage received gastrectomy in Fudan University Shanghai Cancer Center. Clinicopathological features and prognosis of the 2 groups were compared. Results:Tumor location and differentiation were significantly related with NED. The 1 and 3 years survival rates were significantly lower in gastric cancer patients with NED than in those without NED (71%vs 79%, 38%vs 47%,χ2=4.212, P=0.040). The Cox proportional hazard model was used in multivariate analysis. Conclusion:Immunohistochemistry is important to the diagnosis. With NED may be one of the important factors for the poor prognosis of gastric cancer patients.