在胃腺癌中对新辅助疗法的组织学反应的预测因素
Dhouha Bacha1,2, Nour Boudrigua1, Ines Mallek1
1Mongi Slim University Hospital, Pathology Department - La Marsa, Tunis, Tunisia.
概括
预测胃腺癌中新辅助疗法的组织学反应至关重要. 围膜壁侵袭和淋巴结转移的缺失是治疗积极反应的关键指标.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 手术病理学手术病理学
背景情况:
- 周围手术化疗是切除胃腺癌的标准,改善了生存率.
- 对新辅助疗法的组织学反应是一个关键的预后因素.
- 曼达德的瘤回归度 (TRG) 评估了基于残留瘤和纤维化的反应.
研究的目的:
- 确定胃腺癌中新辅助疗法对组织学反应的预测因素.
- 为了提高患者分层和胃癌的治疗计划.
主要方法:
- 用新辅助化疗和手术治疗的胃腺癌患者 (2015-2020年) 的回顾性分析.
- 使用曼达德TRG (等级1-3响应,4-5无响应) 评估的组织学反应.
- 统计分析包括学生的t测试,奇平方测试和多变量逻辑回归 (p<0.05).
主要成果:
- 48%的患者表现出组织学反应 (TRG 1-3),52%的患者没有反应 (TRG 4-5).
- 单变异性分析将反应与瘤大小,分化,壁侵袭,结节状况,pTM阶段和血管/围神经侵袭联系起来.
- 多变量分析确定头顶壁侵袭 (OR=2.351,p=0.022) 和淋巴结转移的缺乏 (OR=1.491,p=0.01) 作为独立的预测因素.
结论:
- 壁侵袭是胃腺癌中新辅助疗法的组织学反应的重要预测因子.
- 淋巴结转移的缺失也独立地预测了更好的组织学反应.
- 这些因素可以帮助预测胃癌患者的治疗结果.
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