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《工程(英文)》 >> 2020年 第6卷 第9期 doi: 10.1016/j.eng.2020.06.007

发生于胃和结直肠的印戒细胞癌的临床特征以及不同部位的转移对预后的预测价值的研究

a State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
b Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, China
c Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, Zhejiang University, Hangzhou 310003, China
d Key Laboratory of Organ Transplantation of Zhejiang Province, Zhejiang University, Hangzhou 310003, China

收稿日期: 2018-11-12 修回日期: 2019-04-18 录用日期: 2019-06-10 发布日期: 2020-06-25

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摘要

印戒细胞癌是胃、结直肠肿瘤中恶性程度最高的病理类型之一。本研究分析了印戒细胞癌的转移特性及其对肿瘤特异性生存率的影响。这项研究纳入了4055例在2010—2012年被诊断为胃印戒细胞癌(signet ring cell carcinoma, SRCC)、结直肠印戒细胞癌患者,其中胃印戒细胞癌2905例,结肠印戒细胞癌和直肠印戒细胞癌1150例。所有临床数据来源于癌症监测、流行病学、最终结果登记资料数据库(SEER)。我们通过卡方检验分析在确诊时伴有远处转移的患者及无远处转移的患者的临床特征。同时用Kaplan-Meier、Cox风险比例回归模型分析出现不同部位转移的患者的预后差异。研究发现,在胃印戒细胞癌患者中,远处淋巴结转移是其最常见的转移部位,而出现脑转移的患者其预后最差。而在患有结肠或直肠的印戒细胞癌患者中,肝脏是其最常见的转移部位,而在确诊时出现远处淋巴结转移的患者的拥有最高的死亡率。总之,出现远处转移常常是预后较差的标志之一,我们的研究结果为印戒细胞癌患者的临床随访、预后分析提供一定的建议。

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