ABSTRACT

Objectives

This work aimed to find the association of mixed-type histology and prognosis of T2/T3 GC patients.

Methods

Eligible T2/T3 gastric cancer patients at our institution were identified. The histological types and risk factors affecting OS were examined. Survival differences were assessed by log-rank tests and Kaplan–Meier curves.

Results

The study identified 972 T2/T3 gastric cancer patients, including 283 differentiated-type patients, 544 undifferentiated-type patients and 145 mixed type. Mixed-type histology was associated with shorter 5-year OS (DT vs UDT vs MT:57.5% vs 44.9% vs 39.6%, P = 0.002). MT histology can be predictive for prognosis of T2/T3 GC patients (HR for OS: 1.386, 95% CI: 1.028–1.868, P = 0.032), and its malignant potential is not inferior to UDT. In the subgroup analysis, MT can potentially be independent risk factor for non-distal GC patients (P = 0.010).

Conclusion

This study reported that mixed histology could be regarded as a potential prognostic factor for T2/T3 gastric cancer patients, especially for those with non-distal cancer. MT patients have higher incidence of metastasis and recurrence and had poorer prognosis than those with pure histological type. It is necessary for MT patients to have preoperative pathological examination for accurate histologic classification, so as to make the comprehensive treatment strategies..

中文翻译：

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分化/未分化混合型是T2/T3胃癌患者的预后因素

摘要

目标

本工作旨在寻找混合型组织学与 T2/T3 GC 患者预后的关联。

方法

确定了我们机构符合条件的 T2/T3 胃癌患者。检查了影响 OS 的组织学类型和危险因素。通过对数秩检验和 Kaplan-Meier 曲线评估生存差异。

结果

该研究确定了972例T2/T3胃癌患者，其中分化型283例，未分化型544例，混合型145例。混合型组织学与较短的 5 年 OS 相关（DT vs UDT vs MT：57.5% vs 44.9% vs 39.6%，P =  0.002）。MT 组织学可以预测 T2/T3 GC 患者的预后（OS 的 HR：1.386，95% CI：1.028-1.868，P =  0.032），其恶性潜能不逊于 UDT。在亚组分析中，MT 可能是非远端 GC 患者的独立危险因素（P =  0.010）。

结论

本研究报道混合组织学可被视为 T2/T3 胃癌患者的潜在预后因素，特别是对于非远端癌患者。与单纯组织学类型相比，MT患者的转移和复发率更高，预后更差。MT患者需要进行术前病理检查，准确进行组织学分型，制定综合治疗策略。