肿瘤沉积与胃癌临床病理特征及预后的相关性分析：多中心回顾性研究。
Correlation Analysis Between Tumor Deposit and Clinicopathologic Characteristics and Prognosis of Gastric Cancer: A Multicenter Retrospective Study.
发表日期：2024 May 30
作者：
Zhixiong Li, Xinyu Li, Shen Guan, Guangwei Zhu, Huimei Lin, Haiyan Wu, Jing Jia, Zipei Guo, Zhiming Cai, Qiajun Zheng, Haoxiang Zhang, Fangqiu Ruan, Xu Zheng, Chunkang Yang, Yanchang Xu, Jianxin Ye
来源：
ANNALS OF SURGICAL ONCOLOGY
摘要：
胃肿瘤沉积物（TD）形成的机制尚不清楚。我们旨在探讨TD形成的危险因素及其预后价值。本回顾性分析包括2014年6月至2018年6月来自中国四家医疗机构的781例局部进展期胃癌（LAGC）患者。单因素分析显示TD阳性与肿瘤直径、Borrmann分型、分化程度、pT分期、pN分期、pTNM分期、神经血管侵犯密切相关(p<0.05)。多变量逻辑回归显示肿瘤直径≥ 5 cm（比值比[OR] 1.836，95%置信区间[CI] 1.165-2.894，p = 0.009）和血管侵犯（OR 2.152，95% CI 1.349-3.433，p = 0.001） ) 是 TD 阳性的独立危险因素。多变量 Cox 分析显示 TD 阳性（OR 1.533，95% CI 1.101-2.134，p = 0.011），肿瘤直径 ≥ 5 cm（OR 1.831，95% CI 1.319-2.541，p < 0.001），pT4a 分期（OR 1.652， 95% CI 1.144-2.386，p = 0.007）和血管侵犯（OR 1.458，95% CI 1.059-2.008，p = 0.021）是GC预后的独立危险因素。 TD阳性组的5年总体生存率和无病生存率在pT4a和pN3b期患者中表现出显着影响（p< 0.05）。TD与LAGC患者的肿瘤直径和血管侵犯密切相关，TD阳性是 LAGC 患者的独立预后因素，尤其是 pT4a 和 pN3b 阶段的患者。© 2024。外科肿瘤学会。
The mechanism underlying the formation of gastric tumor deposits (TDs) is unclear. We aimed to explore the risk factors for the formation and prognostic value of TDs.This retrospective analysis included 781 locally advanced gastric cancer (LAGC) patients from four medical institutions in China, from June 2014 to June 2018. The risk factors for TD formation and prognostic value were determined through univariate and multivariate analyses.Univariate analysis revealed that TD positivity was closely related to tumor diameter, Borrmann classification, differentiation degree, pT stage, pN stage, pTNM stage, and nerve and vascular invasion (p < 0.05). Multivariate logistic regression revealed that tumor diameter ≥ 5 cm (odds ratio [OR] 1.836, 95% confidence interval [CI] 1.165-2.894, p = 0.009) and vascular invasion (OR 2.152, 95% CI 1.349-3.433, p = 0.001) were independent risk factors for TD positivity. Multivariate Cox analysis revealed that TD positivity (OR 1.533, 95% CI 1.101-2.134, p = 0.011), tumor diameter ≥ 5 cm (OR 1.831, 95% CI 1.319-2.541, p < 0.001), pT4a stage (OR 1.652, 95% CI 1.144-2.386, p = 0.007), and vascular invasion (OR 1.458, 95% CI 1.059-2.008, p = 0.021) were independent risk factors for GC prognosis. The 5-year overall and disease-free survival of the TD-positive group showed significant effects among patients in the pT4a and pN3b stages (p < 0.05).TDs are closely related to tumor diameter and vascular invasion in LAGC patients, and TD positivity is an independent prognostic factor for LAGC patients, especially those at pT4a and pN3b stages.© 2024. Society of Surgical Oncology.