胃印戒细胞癌与非印戒细胞癌临床病理分析

Clinical and Pathological Data Analysis of Signet Ring Cell Carcinoma and Non-Signet Ring Cell Carcinoma

目的:通过比较胃印戒细胞癌与非印戒细胞癌的临床特征与病理资料,探讨胃印戒细胞癌的临床特征,病理特点及预后。方法:回顾性分析2005年1月至2007年1月在哈尔滨医科大学附属第三医院住院治疗的1138例胃癌患者临床资料,根据组织学类型分为胃印戒细胞癌组和非印戒细胞癌组,对两组的性别、年龄、家族史、肿瘤发生部位、浸润深度、淋巴结转移、远处转移及根治术后中位进展时间、1年生存率和3年生存率进行统计分析比较。结果:胃印戒细胞癌好发于女性(P<0.05);年龄≤55岁的患者发病率高于非印戒细胞癌(P<0.05),≥56岁的患者发病率低于非印戒细胞癌(P<0.05);肿块生长部位以胃中下部为主(P<0.05),侵犯胃上部者明显少于非印戒细胞癌(P<0.05);胃印戒细胞癌多数在胃壁组织内呈弥漫浸润性生长,垂直浸润能力较弱,突破浆膜层者明显少于非印戒细胞癌(P<0.05);根治术后中位进展时间胃印戒细胞癌(10个月)较非印戒细胞癌(12个月)提前2个月,进展风险增加(P<0.05);胃印戒细胞癌在家族史、淋巴结转移、远处转移及根治术后1年和3年生存率方面与非印戒细胞癌比较无差异。结论:胃印戒细胞癌多发于中青年女性;好发年龄小于56岁;发病部位以胃中下部为主;多呈弥漫性浸润性生长,且较少突破浆膜层;中位进展时间短,进展风险高。

Objective： To investigate the clinical characteristics, pathological characteristics and prognosis of gastric signet ring cell carcinoma and non-signet ring cell carcinoma. Methods： 1138 clinical data of patients with gastric cancer from January 2005 to January 2007 were analyzed. The patients were divided into signet ring cell carcinoma （SRCR）and non-signet ring cell carcinoma （NSRCR）, the gender, age, family history, tumor location, depth of invasion, lymph node and distant metastasis, the median time to progression, 1-year and 3-year survival rate after radical operation of two groups were analyzed. Results： Most patients with SRCR were young females （P〈0.05）; Gastric SRCR had higher incidence in patients≤55 years（P〈0.05）, while the incidence was lower in patients ≥ 56 years, （P〈0.05）; The majority of tumor sites were in the lower part of the stomach （P〈0.05）, violations of the upper stomach was significantly less than NSRCR （P〈0.05）; Most of SRCR were in diffuse infiltrative growth, less in vertical infiltration growth, and the breakthrough ofserosa were significantly less than non-signet ring cell carcinoma （P〈0.05）; The median time to progression after radical resection of gastric SRCR was 2 months in advance, and the risk of progression increased （P〈0.05）; In SRCR, the family history, lymph node metastasis, distant metastasis and 1 year and 3 year survival rates after radical surgery were not statistically different from NSRCR. Conclusion： Young females are prone to SRCR of stomach; The predilection of age was less than 56 years; Most carcinoma site located at mid-downer part of gastric body; Most carcinoma were in diffuse infiltrative growth; The median time to progression after radical resection is short, and the risk of progression was high.