胃癌Lauren分型临床特点及预后分析

白鸽初建虎郑超马乐包永星玛依努尔·艾力

【摘要】目的比较弥漫型胃癌与肠型胃癌临床病理特点及预后。方法回顾性分析603例胃癌患者，其中肠型胃癌297例、弥漫型306例，分析两者在民族、肿瘤大小、淋巴结转移情况、浸润深度、淋巴结及远处转移状况、分化程度和肿瘤TNM分期、Her-2基因状态上的差异。结果与肠型胃癌相比，弥漫型胃癌患者较年轻、女性多见、肿瘤分期多为中晚期、组织分化程度较差、更易出现淋巴结转移及腹膜转移、Her-2基因阳性率偏低、WHO病理分型以低分化、印戒细胞癌为主(P<0.05)。弥漫型与肠型胃癌患者的5年总生存率分别为41.8%和52.8%(P<0.001)。结论弥漫型胃癌组织分化差，肿瘤恶性程度高，预后较差，而肠型胃癌的预后较好。

【关键词】胃癌；Lauren分型；预后

收稿日期：(2015-04-06)

DOI:10.3969/g.issn.0253-9802.2015.10.010

Clinicopathological characteristics and prognosis of gastric adenocarcinoma with different Lauren classificationBaiGe,ChuJianhu,ZhenChao,MaLe,BaoYongxing,MayinurEli.DepartmentofOncology，theFirstAffiliatedHospital,XinjiangMedicalUniversity,Urumqi830011,China

Correspondingauthor，MayinurEli，E-mail:mayinur224@126.com

Abstract【】ObjectiveTo compare the clinicopathological features and prognosis between diffuse- and intestinal-type gastric cancer. MethodsA retrospective analysis of 603 cases of gastric cancer, including 297 cases of intestinal-type and 306 diffuse-type gastric cancer, was conducted to compare the differences in terms of ethnics, tumor size, lymph node metastasis, depth of invasion, lymph node and distant metastasis，differentiation status and TNM staging and Her-2 gene status. ResultsCompared with intestinal-type gastric cancer, diffuse gastric cancer mainly occurred at a younger age of onset, female preponderance, most in moderate and advanced stage of tumor, lower degree of histological differentiation, more likely to have lymph node metastasis and peritoneal metastasis, lower positive rate of Her-2 gene and poorly differentiated signet ring cell carcinoma by WHO pathological classification (P<0.05). The 5-year overall survival of diffuse-type and intestinal-type gastric cancer was 41.8% and 52.8% (P<0.001). ConclusionsDiffuse gastric cancer presents with low histological differentiation, high degree of malignancy and poor prognosis, whereas the clinical prognosis of intestinal-type gastric cancer is better.

【Key words】Gastric cancer; Lauren classification; Prognosis

胃癌是世界上常见的恶性肿瘤之一，其发病率、病死率居所有恶性肿瘤第四位。在我国胃癌居恶性肿瘤发病率的第二位，病死率的第三位。临床中关于胃癌的分期和病理诊断存在不同的标准且争论较多[1]。Lauren分型是临床中简便且有效的胃癌分类方法之一，将胃癌按照Lauren分型可分为：肠型、混合型、弥漫型。一般认为肠型的预后较好，弥漫型预后最差。本文拟研究Lauren分型对于判断胃癌预后的价值。

对象与方法

一、 研究对象

2007年1月至2012年1月入住新疆医科大学第一附属医院的603例胃癌患者，弥漫型胃癌患者297例，其中男120例， 女177例，年龄(46.7±10.2)岁；肠型胃癌患者306例，其中男190例，女116例，年龄(54.7±12.6)岁。随访至2015年3月，各类型的患者在民族、肿瘤大小、淋巴结转移情况、浸润深度、淋巴结及远处转移状况、分化程度和肿瘤TNM分期、Her-2基因状态上进行分析。

二、 研究方法