胃粘液腺癌的临床病理特点及预后

Clinicopathological characristics of mucinous gastric carcinoma

目的探讨胃粘液腺癌 (mucinousgastriccarcinoma ,MUC)与胃非粘液腺癌 (non MUC)的临床病理差异。方法 1 994～ 2 0 0 1年收治的 438例胃癌中粘液癌 36例。比较MUC与non MUC的临床病理及预后。结果MUC比non MUC更易发生浆膜浸润 (T3+T4 :MUC 94 4% ,non MUC 78 9% )、浸润性更强 (BorrmannⅢ型 +Ⅳ型 :MUC 88 9% ,non MUC 56 2 % )和更易发生淋巴结转移 (淋巴结阳性率 :MUC 94 4% ,non MUC 81 1 % )。MUC晚期患者比例 (Ⅲ +Ⅳ :MUC 88 9% ,non MUC 73 9% )和腹膜播散率高 (MUC 2 7 8% ,non MUC 1 2 4% )。MUC比non MUC的根治切除率低 (MUC 69 4% ,non MUC81 1 % )。MUC组的 1年、2年生存率分别为 50 5 %、33 1 % ,中位生存期为 1 2 2个月 ;non MUC组的1年、2年生存率分别为 74 9%、64 7% ,5年生存率为 31 % ,中位生存期为 2 8 9个月 ,二者差异有显著意义 (P <0 0 1 )。结论MUC的预后差 ,与确诊时中晚期比例和浆膜浸润率、淋巴结转移率。

ObjectiveTo investigate the clinicopathological characristics of mucinous gastric carcinoma (MUC). MethodsFrom 1994 to 2001, 438 gastric cancer patients underwent operation, among them, 36 patients (8 2%) were with MUC. The clinicopathological parameters and prognosis of MUC and non MUC were analyzed retrospectively. ResultsThere were no significant differences in age, sex, tumor site and hepatic metastasis. Patients with MUC had higher rate of serosal invasion, invasive type lymph node involvement, peritoneal dissemination. Patients with MUC were of more advanced stage (stage Ⅲ and Ⅳ:MUC 88 9%,non MUC 73 9%). The 1 year and 2 year survival rate for MUC patients was lower than that for non MUC patients (50 5%?33 1% vs. 74 9%?64 7%). Conclusions The poor prognosis of MUC was correlated with frequent serosal invasion, lymph node involvement, peritoneal dissemination, and advanced stage at the time of diagnosis.