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1.
BACKGROUND AND OBJECTIVES: To evaluate the prognostic value of metastatic lymph node ratio in gastric carcinoma. METHODS: One hundred and sixty four patients who underwent D(2) dissection for gastric carcinoma at Ankara Oncology Hospital were reviewed retrospectively. The prognostic factors including Japanese classification, AJCC/UICC TNM classification and metastatic lymph node ratio (1-10% and >10%) were evaluated in univariate and multivariate Cox regression analysis. RESULTS: The multivariate analysis showed that Borrmann classification, pN-category of AJCC/UICC classification and metastatic lymph node ratio were the most significant prognostic factors and a higher hazard ratio was obtained for metastatic lymph node ratio than pN category of AJCC/UICC classification (4.5 vs. 11.4). When the metastatic ratio groups of 1-10% and >10% were subdivided into pN(1), pN(2) and pN(3) categories of the AJCC/UICC classification, there was no statistical difference between survival curves. When pN(1), pN(2) and pN(3) categories of the AJCC/UICC classification were subdivided into the ratio groups of 1-10% and >10%, the survival rate of ratio group 1-10% was better than ratio group >10%. CONCLUSION: With its simplicity and reproducibility, metastatic lymph node ratio can be used as a reliable prognostic indicator. 相似文献
2.
AIMS AND BACKGROUND: The status of the axillary lymph nodes at the time of diagnosis has been accepted as one of the most important prognostic factors for the overall and disease-free survival of patients with breast cancer. The aim of our study was to determine which factors influence axillary node involvement in invasive breast cancer. METHODS: The data presented here were obtained from 344 patients who were treated for invasive breast cancer at the Department of Radiation Oncology, Uluda? University Medical College, Bursa, Turkey. Possible prognostic factors were categorized as patient related and tumor related. The Mann-Whitney U test was used for univariate analysis and logistic regression was used for multivariate analysis. RESULTS: In univariate analysis, a familial cancer history (P = 0.0042), age < 40 years (P = 0.0276), higher T stage (P < 0.0000), nipple involvement (P = 0.0345), skin involvement (P = 0.0270), perineural invasion (P = 0.0231), and lymphatic vessel invasion (P < 0.0000) were correlated with increased axillary node involvement. A higher incidence of > or = 4 involved lymph nodes was associated with higher T stage (P = 0.0004), nipple involvement (P = 0.0292), presence of an extensive intraductal component (P = 0.0023), skin involvement (P = 0.0008), perineural invasion (P = 0.0523), and lymphatic vessel invasion (P < 0.0000) in univariate analysis. In multivariate analysis, age < 40 years (P = 0.0454), cancer history within the family (P = 0.0024), higher T stage (P = 0.0339), lymphatic vessel invasion (P = 0.0003), and perineural invasion (P = 0.0408) were found to be independent factors for axillary lymph node positivity. Age < 40 years (P = 0.0221), perineural invasion (P = 0.0408), and an extensive intraductal component (P = 0.0132) were associated with an increased incidence of > or = 4 involved nodes in the logistic regression analysis. In patients with breast cancer, the incidence of axillary lymph node involvement was independently influenced by age < 40 years, presence of cancer history within the family, higher T stage, lymphatic vessel invasion, and perineural invasion. CONCLUSIONS: In conclusion, absence of familial cancer history, presence of lymphatic vessel invasion, higher T stage, and age below 40 years independently increased the risk of axillary node involvement. Presence of perineural invasion and lymphatic vessel invasion, age below 40, and an extensive intraductal component of more than 25% independently affected the risk of having > or = 4 nodes involved. Patients characterized by these factors may be classified into a higher risk group for nodal involvement, but more data are needed to define factors that can help in the decision-making regarding the omission of axillary treatment. 相似文献
3.
Jun Lu Chang-ming Huang Chao-hui Zheng Ping Li Jian-wei Xie Jia-bin Wang Jian-xian Lin 《Surgical oncology》2013,22(3):167-171
ObjectiveTo investigate whether addition of tumor size improves the prognostic accuracy of the UICC 7th TNM staging system in gastric cancer patients who underwent radical surgery (R0 resection).MethodsThe clinical and pathological data and postoperative 5-year survival rate of 507 patients with gastric cancer who underwent radical surgery (R0 resection) in our department from January 2004 to June 2006 were evaluated retrospectively. The prognostic accuracy of conventional UICC 7th TNM staging was compared with that of UICC 7th TNM staging plus tumor size. The ability of tumor size to improve the 95% confidence interval (CI) of postoperative 5-year survival rate in gastric cancer patients was assessed.ResultsOf the 507 patients, 470 (92.7%) were followed up. The five-year survival rate of these patients was 50.4%. The survival rates of patients with pT1, pT2, pT3, and pT4 stage tumors were 89.3%, 72.4%, 36.9%, and 23.7%, respectively (P < 0.05), and the survival rates of patients with pN0, pN1, pN2, and pN3 stage tumors were 75.2%, 68.8%, 46.7%, and 21.3% (P < 0.05). Depth of invasion, lymph node metastasis stage, metastatic lymph node ratio (MLR), lymphatic invasion and tumor size were independent predictors of patient prognosis. The accuracy of UICC 7th TNM staging in predicting 5-year survival was 75.4% and the accuracy of tumor size plus the UICC 7th TNM staging was 77.9% (P < 0.05). This combination improved the 95% CI of postoperative 5-year survival rate in gastric cancer patients.ConclusionTumor size can improve the accuracy of UICC 7th TNM staging in predicting survival in gastric cancer patients following radical surgery (R0 resection). Tumor size is likely to be another important indicator in future UICC-TNM staging systems for gastric cancer patients. 相似文献
4.
BACKGROUND: A new system for the classification of gastric carcinoma, based on the number of metastatic lymph nodes, has been adopted by the current American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) TNM system (1997). The purpose of this study was to evaluate the rationality of this classification in comparison with the Japanese classification, which is based on the location of positive lymph nodes. METHODS: The authors analyzed 587 patients who underwent clinically curative gastrectomy with D2 lymphadenectomy for gastric carcinoma and each had 15 or more lymph nodes histologically examined from 1982 to 1992. Multivariate analysis with the Cox proportional hazards model was carried out to determine which classification was more effective. RESULTS: Within the pN1 or pN2 category of the new AJCC/UICC system, no significant difference in the survival rates existed between n1 patients and n2 patients of the Japanese classification. On the other hand, the survival rates significantly decreased, in the order of pN1, pN2, and pN3 (from greatest to smallest decrease), within the n1 and n2 categories. In multivariate analysis, lymph node involvement by the AJCC/UICC classification was selected as the most significant prognostic determinant, whereas the Japanese lymph node classification was not significantly prognostic. When survival rates were calculated within the pT1, pT2, and pT3-4 categories, no differences existed between pN0 and pN1. There was some discrepancy between the survival rate for each pT and pN category and the corresponding stage. CONCLUSIONS: The new AJCC/UICC classification for lymph node involvement of gastric carcinoma is basically acceptable and considered superior to the Japanese classification. Further analysis involving a greater number of cases may be necessary to confirm the applicability of this staging system. 相似文献
5.
《European journal of surgical oncology》2020,46(10):e27-e32
BackgroundThe TNM system of the International Union for Cancer Control/American Joint Committee on Cancer (UICC/AJCC) and the Japanese Gastric Cancer Association (JGCA) systems are the most used lymph node (LN) staging systems in gastric cancer. This study estimated the influence of anatomic location-based node stations on survival and proposed a new staging method based on both the number and anatomical distribution of metastatic LNs (mLNs).MethodsStage I–III gastric cancer patients with radical gastrectomy were retrospectively evaluated. Overall survival (OS) was estimated in 1786 patients with UICC/AJCC stage N1–N3b disease and compared with estimates obtained using JGCA group 1–3 mLN staging.ResultsThe OS of UICC/AJCC stage N1–N3b patients with group 2 JGCA mLNs was significantly worse than that of patients with only group 1 mLNs. The OS of the patients with group 2 mLNs was similar to that of patients with group 1 mLNs but in the next more advanced UICC/AJCC-N stage. The OS of patients with group 3 mLNs was worse than that of patients with any UICC/AJCC-N stage and was similar to that of N3b patients with group 2 mLNs. A new pathological node (pN) staging classification was developed that advanced the N-staging of patients with group 2 mLNs. It was a better indicator of prognosis than the eighth UICC/AJCC-N and the thirteenth JGCA group staging systems.ConclusionsA simple, accurate pN staging system including both the number and location of mLNs had improved homogeneity, discriminatory ability, and gradient monotonicity. 相似文献
6.
Background
The most important prognostic factor after curative surgery for gastric carcinoma is the presence of lymph node metastases. According to the 7th edition of the UICC TNM staging system for gastric cancer, N classification was categorized as N0 (no regional lymph node metastasis), N1 (1?C2 regional lymph node metastases), N2 (3?C6 regional lymph node metastases), and N3 (7 or more regional lymph node metastases). The purpose of this study was to evaluate the rationality of the new UICC/AJCC N classification in comparison with the 6th UICC classification.Methods
From August 2002 to July 2006, 295 patients with gastric cancer underwent curative resection with D2 lymph node dissection by a single surgeon. We analyzed retrospectively the significant prognostic factors and identified the suitability of the 7th UICC N staging system.Results
According to the 7th UICC N classification, the 5-year cumulative survival rates (5-YSR) of N0, N1, N2, N3a, and N3b were 89.7, 73.6, 54.9, 23.1, and 5.4%, respectively (P?<?0.0001). Using univariate analysis, the N classification of the 7th and 6th UICC/AJCC TNM staging system, T classification of the 7th UICC TNM staging system, size and location of tumor, and histology were associated with the overall survival of gastric cancer after curative surgery. However, Cox regression multivariate analysis showed the 7th UICC N classification was an independent prognostic factor instead of the 6th UICC N classification (P?<?0.0001).Conclusion
The 7th UICC classification for lymph node metastasis is thought to be a more reliable prognostic factor for gastric cancer than the 6th classification. 相似文献7.
Clinicopathologic characteristics and prognostic factors in 10 783 patients with gastric cancer 总被引:9,自引:0,他引:9
Background. Although the results of gastric cancer treatment have markedly improved, this disease remains the most common cause of cancer
death in Korea.
Methods. Clinicopathologic characteristics were analyzed for 10 783 consecutive patients who underwent operation for gastric cancer
at the Department of Surgery, Seoul National University Hospital, from 1970 to 1996. We also evaluated survival and prognostic
factors for 9262 consecutive patients operated from 1981 to 1996. The clinicopathologic variables for evaluating prognostic
values were classified as patient-, tumor-, and treatment-related factors. The prognostic significance of treatment modality
[surgery alone, surgery + chemotherapy, surgery + immunotherapy + chemotherapy (immunochemosurgery)] was evaluated in patients
with stage III gastric cancer (according to the International Union Against Cancer TNM classification of 1987). For the assessment
of lymph node metastasis, both the number of involved lymph nodes and the ratio of involved to resected lymph nodes were analyzed,
as a quantitative system.
Results. The mean age of the 10 783 patients was 53.5 years and the male-to-female ratio was 2.07 : 1. Resection was performed in
9058 patients (84.0% resection rate). The 5-year survival rates were 55.9% for all patients and 64.8% for patients who received
curative resection. Age, sex, preoperative hemoglobin and albumin levels, type of operation, curability of operation, tumor
location, Borrmann type, tumor size, histologic differentiation, Lauren's classification, perineural invasion, lymphatic invasion,
vascular invasion, depth of invasion, number of involved lymph nodes, ratio of involved to resected lymph nodes, and distant
metastasis had prognostic significance on univariate analysis. Radical lymph node dissection, with more than 25 resected lymph
nodes improved survival in patients with stage II and IIIa disease. As postoperative adjuvant therapy, immunochemotherapy
was most effective in patients with stage III disease. Patients with identical numbers of lymph nodes -either the number of
involved lymph nodes or the number of resected lymph nodes- were divided according to their ratios of involved-to-resected
lymph nodes. In each numeric group, there were significant survival differences according to the ratio of involved-to-resected
lymph nodes. However, patients who had the same involved-to-resected lymph node ratio did not show significant differences
in survival rate according to either the number of involved or the number of resected lymph nodes. On multivariate analysis,
curability of operation, depth of invasion, and ratio of involved to resected lymph nodes were independent significant prognostic
factors.
Conclusions. Curative resection, depth of invasion, and lymph node metastasis were the most significant prognostic factors in gastric
cancer. With regard to the status of lymph node metastasis, the ratio of involved to resected lymph nodes had a more precise
and comprehensive prognostic value than only the number of involved or resected lymph nodes. Early detection and curative
resection with radical lymph node dissection, followed by immunochemotherapy, particularly in patients with stage III gastric
cancer should be the standard treatment in principle, for patients with gastric cancer.
Received for publication on Apr. 13, 1998; accepted on Oct. 22, 1998 相似文献
8.
Prospective evaluation of prognostic factors in patients with colorectal cancer undergoing curative resection 总被引:8,自引:0,他引:8
Fujita S Shimoda T Yoshimura K Yamamoto S Akasu T Moriya Y 《Journal of surgical oncology》2003,84(3):127-131
BACKGROUND AND OBJECTIVES: Streak type, defined by the presence of white streaks at the advancing margin of tumor invasion; focal dedifferentiation, seen as undifferentiated cancer cells with an infiltrative pattern at the invasive front; and perineural invasion have been demonstrated to be prognostic factors in patients with colorectal cancer. We performed a prospective study to examine the usefulness of these features as prognostic factors. METHODS: We reviewed a total of 391 patients who underwent curative surgery for colorectal cancer between May 1997 and June 1999. Of these, 50 patients with multiple cancers were excluded, and a total of 341 patients were finally entered into the study. RESULTS: Of the prognostic factors investigated, depth of invasion, lymph node status, lymphatic invasion, venous invasion, growth type, streak type, focal dedifferentiation, and perineural invasion were significant prognostic factors in univariate analysis. In multivariate analysis, lymph node status, depth of invasion, and perineural invasion were significant prognostic factors. The survival of patients with perineural invasion was significantly poorer than that of patients without perineural invasion in both stage II and III cancer. CONCLUSIONS: Perineural invasion status can be used to facilitate the selection of colorectal cancer patients for adjuvant chemotherapy and should be described in routine pathology reports. 相似文献
9.
Caigang Liu Ruishan Zhang Yang Lu Hua Li Ping Lu Fan Yao Feng Jin Huimian Xu Shubao Wang Junqing Chen 《Surgical oncology》2010,19(1):4-10
BackgroundLymphatic vessel invasion is an important prognostic factor for the gastric cancer without lymph node metastasis. However, the studies on early gastric cancers is still sparse. Therefore, we carried out this study to determine clinicopathological and surgical prognostic factors, especially lymphatic vessel invasion, for early gastric cancers.MethodsClinicopathological characteristics and prognostic outcomes of 188 patients who received a gastrectomy for early gastric cancer between 1980 and 2000 were retrospectively evaluated based on the subclassification of pN category. A multivariate analysis was performed by using the Cox regression model, where lymphatic vessel invasion and other potential prognostic factors were included.ResultsOf the 188 patients, 158 had T1N0M0 and 30 T1N1M0 cancers. In patients with T1N0M0 cancers, the survival rate was significantly lower in those with lymphatic vessel invasion than in those without (χ2 = 4.025, P = 0.045). However, in patients with T1N1M0 cancers, the survival rates were not significantly different between those with and those without lymphatic vessel invasion (χ2 = 0.253, P = 0.615). The multivariate analysis identified that age (P = 0.033) and lymph node metastasis (P = 0.019) were independent prognostic factors for all early gastric cancers. However, age (P = 0.042), tumor location (P = 0.032), and lymphatic vessel invasion (P = 0.010) were the independent prognostic factors for T1N0M0 cancers.ConclusionsLymphatic vessel invasion was an independent prognostic factor for T1N0M0 early gastric cancers, and thus may be a potential prominent factor that should be considered to be included in the category of lymphoid metastasis (both lymph node metastasis and lymphatic vessel invasion) in patients with early gastric cancer. 相似文献
10.
11.
Betge J Pollheimer MJ Lindtner RA Kornprat P Schlemmer A Rehak P Vieth M Hoefler G Langner C 《Cancer》2012,118(3):628-638
BACKGROUND:
Blood vessel invasion has been associated with poor outcome in colorectal cancer (CRC), whereas the prognostic impact of lymphatic invasion is less clear. The authors of this report evaluated venous and lymphatic invasion as potential prognostic indicators in patients with CRC focusing on lymph node‐negative patients and compared routine and review pathology diagnoses.METHODS:
In total, 381 tumors from randomly selected patients were retrospectively reviewed. The presence of vascular invasion was related to disease‐free and cancer‐specific survival using the Kaplan‐Meier method. For multivariable analysis, Cox proportional hazards regression models were performed.RESULTS:
Lymphatic invasion and venous invasion were observed in 126 patients (33%) and 87 patients (23%), respectively, and were associated significantly with tumor classification, lymph node status, American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) disease stage, tumor differentiation, pattern of invasion, and extent of tumor budding. The detection of vascular invasion was related to the number of examined tissue blocks. Venous and lymphatic invasion proved to be significant prognostic variables in univariable and multivariable analyses. Extramural vascular involvement was of particular significance. When the analysis was restricted to patients with (AJCC/UICC) stage II disease, venous invasion, but not lymphatic invasion, was identified as an independent prognostic variable. Review pathology diagnoses differed significantly from routine diagnoses with respect to prognostic impact.CONCLUSIONS:
Venous and lymphatic invasion proved to be significant prognostic variables in patients with CRC. The detection of vascular invasion and, consequently, risk stratification of affected patients were related to the quality of pathology workup, ie, the number of examined tissue blocks. Observed differences between review and routine pathology diagnoses illustrated the need for high‐quality pathology reporting and also for standardized quality control. Cancer 2012;. © 2011 American Cancer Society. 相似文献12.
目的探讨淋巴结转移率对胃癌患者预后预测的意义。方法回顾性分析我院238例胃癌根治术患者的术后病理资料,分析胃癌患者预后和UICC/AJCC N分期及淋巴结转移率的关系。结果患者术后5年累计生存率为42.0%,UICC/AJCC N分期和淋巴结转移率均是胃癌患者的预后预测因素。根据UICC/AJCC N分期系统,获得淋巴结总数大于15枚和少于15枚的同一N分期患者术后5年生存率存在显著差异。但根据淋巴结转移率分期系统,淋巴结总数大于15枚和少于15枚的同一淋巴结转移率分期患者预后无显著差异。结论淋巴结转移率是胃癌患者的简单、可靠的预后预测因素,可以防止获得淋巴结总数不足导致的N分期降低。 相似文献
13.
Predictors of long-term survival in pN3 gastric cancer patients 总被引:3,自引:0,他引:3
BACKGROUND AND OBJECTIVES: Patients with pN3 gastric cancer are classified as having a stage IV disease just by virtue of having more than 15 metastatic lymph nodes according to the 5th UICC cancer staging criteria. We tried to verify whether the pN3 gastric cancer patients truly constitute a homogeneous group with the same poor prognosis by looking for predictors of long-term survival within the group. METHODS: Medical records of 347 patients who had gastrectomy with D2/D3 lymph node dissection for gastric cancer and diagnosed with pN3 disease by pathology, between January 1987 and December 1997 were reviewed. Clinicopathologic prognostic variables were evaluated as predictors of long-term survival by univariate and multivariate analysis. RESULTS: The overall 5-year survival rate was 13.0% (95% CI, 9.3-16.6%). The extent of gastric resection and metastatic lymph node ratio were significant independent predictors of long-term survival on multivariate analysis. The 5-year survival rates for the subtotal and total gastrectomy groups were 18.2 and 8.8%, respectively. The 5-year survival rate according to the metastatic lymph node ratio was 20.2, 8.9, and 1.9% when the ratio was <0.33, 0.33-0.67, and > 0.67, respectively. CONCLUSIONS: Patients with pN3 gastric cancer appear to be a heterogeneous group with clinicopathologic predictors that identify subgroups with significantly different long-term prognoses. The metastatic lymph node ratio may serve as a valuable tool to predict the long-term prognosis of these patients. 相似文献
14.
15.
Background.
The prognosis of stage IV gastric cancer is poor with the 5-year survival rate still being about 10%.
Methods.
We classified 130 patients with stage IV gastric cancer into four groups: peritoneal metastasis, liver metastasis, lymph
node metastasis, and multiple factor groups, according to the factors that determined stage IV in each patient and compared
survival in the four groups. We also performed univariate and multivariate analyses of various prognostic clinicopathological
factors. The 5-year survival rate in the patients with stage IV gastric cancer was 7.4%.
Results.
No significant differences were observed in survival among the four groups. Univariate analysis showed significant differences
in survival among the categories of lymphatic invasion (
P
= 0.0045), venous invasion (
P
= 0.0024), peritoneal metastasis (
P
= 0.0019), postoperative chemotherapy (
P
= 0.0385), curability (
P
= 0.0001), and lymph node dissection (
P
= 0.0001). In the curability B group, survival was prolonged in the postoperative chemotherapy group. Multivariate analysis
revealed the highest relative hazard (RH) for lymph node dissection (RH, 2.261), followed, in descending order, by curability
(RH, 1.905), peritoneal metastasis (RH, 1.896), lymphatic invasion (RH, 1.736), and venous invasion (RH, 1.481).
Conclusion.
As prognostic factors in stage IV gastric cancer, the tumor factors of peritoneal metastasis and vessel invasion, and the
treatment factors of curability and lymph node dissection may be important, and active treatment appears to improve survival.
Received: March 2, 2000 / Accepted: June 2, 2000 相似文献
16.
Kunisaki C Shimada H Nomura M Matsuda G Otsuka Y Ono H Akiyama H 《Journal of surgical oncology》2006,94(3):212-219
BACKGROUND AND OBJECTIVES: The prognosis for patients with pN0 gastric cancer is moderately hopeful (expected 5-year survival: 80%). However, the relevant prognostic factors and most appropriate surveillance protocol have not been identified. METHODS: We investigated 733 gastric cancer patients without lymph node metastasis for prognostic factors by uni- and multi-variate analysis and by documenting causes of death and recurrence patterns. RESULTS: Univariate analysis revealed that age, tumor location, macroscopic appearance, tumor diameter, invasion depth, lymphatic invasion, and venous invasion affected prognosis. Multivariate analysis showed that age (> or = 60 years), ill-defined macroscopic appearance, and undifferentiated histological type independently reduced survival rates. Age (> or = 60 years) and undifferentiated histological type adversely influenced prognosis in 507 early gastric cancer patients whereas ill-defined macroscopic appearance adversely affected prognosis in 226 advanced cancer patients. Recurrence patterns in these patients were similar to those produced by lymph node metastasis. The predominant recurrence pattern was peritoneal dissemination, observed 2-3 years post-resection. CONCLUSIONS: This study identified adverse prognostic factors in pN0 gastric cancer patients. Randomized controlled studies of adjuvant chemotherapy are necessary to assess whether such therapy is beneficial for patients with adverse prognostic factors. 相似文献
17.
18.
Yasuaki Nakajima Kagami Nagai Satoshi Miyake Kenichi Ohashi Tatsuyuki Kawano Takehisa Iwai 《Japanese journal of cancer research》2002,93(3):305-312
Lymph node metastasis is a major prognostic factor for esophageal squamous cell carcinoma (ESCC). In recent years, endoscopic mucosal resection (EMR) has been developed with excellent results for the treatment of the superficial ESCC. To make the EMR treatment successful, it is important to establish a good indicator to identify ESCC patients at a high risk of lymph node metastasis. In this study, we examined clinicopathological and immunohistochemical factors to investigate the factors involved in lymph node metastasis of ESCC invading to the submucosal layer (sm-ESCC). Surgical specimens from 84 sm-ESCC patients were examined. Among 84 sm-ESCC patients, 33 (39.3%) had lymph node metastases. Clinicopathologically, tumor depth, lymphatic invasion and blood vessel invasion showed significant correlations with lymph node metastasis by univariate analysis. Tumor depth and lymphatic invasion showed significant correlations by multivariate analysis of these factors. Immunohistochemically, P53 accumulation was observed in 45 cases (53.6%), cyclin D1 overexpression in 25 (29.8%), and pRB in 65 (77.4%). P53 accumulation, cyclin D1 overexpression and MIB-1 Labeling Index were significantly associated with lymph node metastasis by univariate analysis, and P53 accumulation showed a significant correlation with lymph node metastasis by multivariate analysis. Among tumor depth, lymphatic invasion and P53 accumulation, tumor depth and lymphatic invasion were significantly correlated with lymph node metastasis (P = 0.0023 and P = 0.0092, respectively) by multivariate analysis. These data suggest that tumor depth and lymphatic invasion can be considered as good indicators for lymph node metastasis among patients with sm-ESCC. In addition, P53 accumulation could be helpful to identify the patients who need additional treatment after EMR. 相似文献
19.
Evaluation of an Indicator for Lymph Node Metastasis of Esophageal Squamous Cell Carcinoma Invading the Submucosal Layer 总被引:1,自引:0,他引:1
Yasuaki Nakajima Kagami Nagai Satoshi Miyake Kenichi Ohashi Tatsuyuki Kawano Takehisa Iwai 《Cancer science》2002,93(3):305-312
Lymph node metastasis is a major prognostic factor for esophageal squamous cell carcinoma (ESCC). In recent years, endoscopic mucosal resection (EMR) has been developed with excellent results for the treatment of the superficial ESCC. To make the EMR treatment successful, it is important to establish a good indicator to identify ESCC patients at a high risk of lymph node metastasis. In this study, we examined clinicopathological and immunohistochemical factors to investigate the factors involved in lymph node metastasis of ESCC invading to the submucosal layer (sm-ESCC). Surgical specimens from 84 sm-ESCC patients were examined. Among 84 sm-ESCC patients, 33 (39.3%) had lymph node metastases. Clinicopathologically, tumor depth, lymphatic invasion and blood vessel invasion showed significant correlations with lymph node metastasis by univariate analysis. Tumor depth and lymphatic invasion showed significant correlations by multivariate analysis of these factors. Immunohistochemically, P53 accumulation was observed in 45 cases (53.6%), cyclin D1 overexpression in 25 (29.8%), and pRB in 65 (77.4%). P53 accumulation, cyclin D1 overexpression and MIB-1 Labeling Index were significantly associated with lymph node metastasis by univariate analysis, and P53 accumulation showed a significant correlation with lymph node metastasis by multivariate analysis. Among tumor depth, lymphatic invasion and P53 accumulation, tumor depth and lymphatic invasion were significantly correlated with lymph node metastasis ( P =0.0023 and P =0.0092, respectively) by multivariate analysis. These data suggest that tumor depth and lymphatic invasion can be considered as good indicators for lymph node metastasis among patients with sm-ESCC. In addition, P53 accumulation could be helpful to identify the patients who need additional treatment after EMR. 相似文献
20.
To investigat the clinical significance of Ezrin in the development and progression of gastric cancer. Immunohistochemistry
was employed to analyze Ezrin expression in 436 clinicopathologically characterized gastric cancer cases. Ezrin protein levels
were up-regulated in gastric cancer lesions compared with adjacent noncancerous tissues. Positive expression of Ezrin correlated
with age, size of tumor, location of tumor, depth of invasion, vessel invasion, lymph node and distant metastasis and TNM
stage. In stages I, II and III, the 5 year survival rate of patients with a high expression of Ezrin was significantly lower
than those in patients with low expression. In stage IV, Ezrin expression did not correlate with the 5 year survival rate.
Further multivariate analysis suggested that the depth of invasion, lymph node and distant metastasis, TNM stage, and up-regulation
of Ezrin were independent prognostic indicators for the disease. Expression of Ezrin in gastric cancer is significantly associated
with lymph node and distant metastasis, and poor prognosis. Ezrin protein could be useful markers to predict tumor progression
and prognosis. 相似文献