肿瘤间质比在胃癌术后患者预后评估中的临床价值

Clinical Value of Tumor Stromal Ratio in the Prognostic Evaluation of Patients After Gastric Cancer

目的探讨肿瘤间质比(TSR)在胃癌术后患者预后评估中的临床价值。方法选取80例胃癌患者作为研究对象,所有患者均行根治性胃切除及D2淋巴结清扫术。行TSR检查,以TSR低者为最终取值。以80例患者TSR的中位值为界分为高间质比组和低间质比组,并进行长期随访,统计所有患者总生存期及无病生存期,并采用COX回归分析影响总生存期及无病生存期的危险因素。结果80例胃癌患者,其中高间质比37例,低间质比43例。2组T分期、N分期、TNM分期、淋巴血管侵犯及神经周围浸润相比,差异有统计学意义(P<0.05)。中位随访时间27个月(6~46)个月,80例患者中25例死亡(31.25%),55例存活(68.75%);80例患者3年总生存率为73.75%(59/80),3年无病生存率为42.50%(34/80)。高间质比组3年总生存率为89.19%(33/37),高于低间质比组的60.47%(26/43);高间质比组3年无病生存率为56.76%(21/37),高于低间质比组的30.23%(13/43),差异有统计学意义(χ^(2)=8.476、5.725,P=0.004、0.016)。COX多因素回归分析显示,TNM分期、神经周围浸润、TSR为影响胃癌术后患者总生存期及无病生存期的独立危险因素(P<0.05)。结论TSR在评估胃癌术后患者预后中具有较高价值,低肿瘤间质比患者预后不良发生风险较高,可纳入常规病理检查。

Objective To explore the clinical value of tumor interma ratio(TSR)in the prognosis evaluation of patients after gastric cancer.Methods 80 gastric cancer patients were selected as the study subjects,and all the patients underwent radical gastrectomy and D2 lymph node dissection.TSR was performed,taking those with low TSR as the final value,high TSR exceeded 50%,and not low interstitial group.Long-term follow-up.The overall survival and disease-free survival of all patients were counted,and the risk factors affecting overall survival and disease-free survival were analyzed by COX regression.Results In 80 patients with gastric cancer,37 patients had high interstitial ratio,Low interstitial ratio in 43 cases;Compared with the 2 groups:T stage,N stage,TNM stage,lymphovascular invasion and perinerve invasion,The difference was statistically significant(P<0.05);Median follow-up time was 27 months(6-46)months,25 out of the 80 patients died(31.25%),55 patients survived(68.75%);The 3-year overall survival rate of the 80 patients was 73.75%(59/80);After the R0 resection,41 relapsed(51.25%),The 3-year disease-free survival rate was 42.50%(34/80);The 3-year overall survival rate in the high interstitial ratio group was 89.19%(33/37),Higher than 60.47%(26/43),The 3-year disease-free survival rate was 56.76%(21/37),Higher than 30.23%(13/43)of the low interstitial ratio group,The difference was significantly significant(χ^(2)=8.476,5.725,P=0.004,0.016);The COX multivariate regression analysis showed that,TNM stage,perineural infiltration,and TSR were the independent risk factors affecting the overall survival and disease-free survival of GC patients after surgery(P<0.05).Conclusion TSR has a high value in evaluating patient prognosis after gastric cancer.Low tumor stroma has a higher risk of poor prognosis than patients,and can be included in routine pathological examination.