具有外分泌及神经内分泌成分的胃癌中神经内分泌成分对预后影响的研究

发布时间：2018-09-10 05:57

【摘要】：背景:在临床工作中,同时具有外分泌及神经内分泌成分的胃癌并不少见,从单纯腺癌中散在分布神经内分泌细胞(NECs)到神经内分泌癌中存在局灶腺癌成分均属性该类肿瘤。神经内分泌成分在肿瘤中所占比例的不同对该肿瘤预后的影响,目前尚不清楚。方法:本课题回顾性分析了 2011年2月至2016年1月期间,在国家癌症中心/中国医学科学院肿瘤医院进行胃癌D2根治术、病理诊断为具有腺癌及神经内分泌成分的胃癌的95例患者的临床资料。我们分别采用10%,20%,30%,50%和70%作为神经内分泌所占的比例为界限来进行对照研究,分析患者的总生存期(OS)。使用Cox比例风险模型来分析影响预后的因素,通过Kaplan-Meier方法来绘制生存曲线,并使用Log-rank检验来比较生存曲线之间的差别。结果:95例患者的1年,2年,3年和4年总生存率分别为95.3%,83.8%,74.7%,70.5%。多因素分析结果显示肿瘤直径(≥4.7cm)(危险度[HR],2.246;95%可信区间[CI]为,1.721-2.785);pN3(HR,5.159;95%CI,1.032-19.342)与 OS 有着显著相关性(P0.05)。而神经内分泌比例的差别与总生存率并无显着相关性。结论:在具有腺癌及神经内分泌成分的胃癌中,神经内分泌所占比例的差异,并不影响患者的OS,只有肿瘤的直径和转移的淋巴结数目是独立的预后影响因素。
[Abstract]:Background: gastric cancer with both exocrine and neuroendocrine components is not uncommon in clinical work. From (NECs) scattered in neuroendocrine cells in simple adenocarcinoma to focal adenocarcinoma in neuroendocrine carcinomas, the presence of this type of tumor is not uncommon. The effect of the proportion of neuroendocrine components on the prognosis of the tumor is unclear. Methods: from February 2011 to January 2016, D2 radical gastrectomy for gastric cancer was performed at the National Cancer Center / Cancer Hospital of the Chinese Academy of Medical Sciences. Clinical data of 95 patients with adenocarcinoma and neuroendocrine components diagnosed by pathology. We used 50% and 70%, respectively, as the limit of the proportion of neuroendocrine, to analyze the total survival time (OS).) of the patients. Cox proportional risk model was used to analyze the prognostic factors, Kaplan-Meier method was used to draw survival curve, and Log-rank test was used to compare the difference between survival curves. Results the overall survival rate of 95 patients with 1 year, 2 years, 3 years and 4 years was 95.3% and 83.8% respectively. Multivariate analysis showed that tumor diameter (鈮，

本文编号：2233560