摘要：肿瘤出芽与多种肿瘤的不良预后有关，但其在胃癌中的预后意义尚不明了。本研究旨在评价胃腺癌及其主要组织学类型中肿瘤出芽的预后意义。纳入本回顾性队列研究的583例病例均为1983~2016年在Oulu大学医院接受过手术治疗的胃腺癌病例。镜下观察计数原诊断用病理切片中每0.785mm2视野面积下肿瘤出芽的数量。根据肿瘤出芽数量将患者分为低出芽组（<10个）和高出芽组（≥10个）。分析肿瘤出芽与5年生存率以及总生存率的关系。采用Cox回归分析校正混杂因素评估95%可信区间（confidence intervals，CI）的风险比（hazard ratios，HR）。弥漫型胃癌由于其非黏附性生长模式难以确定肿瘤出芽情况。高出芽组患者5年生存率较低出芽组更低（校正HR，1.55；95%CI，1.20~2.01）。肠型腺癌高出芽组患者的5年生存率明显低于低出芽组（校正HR，1.57；95%CI，1.14~2.15）。而弥漫型腺癌不同肿瘤出芽组患者5年生存率无差异。总之，肿瘤高出芽是胃腺癌的一个独立预后因素，但仅限于肠型胃腺癌。弥漫型胃腺癌肿瘤出芽评判几乎不可行，且肿瘤出芽与预后没有相关性。
关键词 ：胃癌，肿瘤出芽，预后
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©2018 Wolters Kluwer Health
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【本文经《美国外科病理学杂志》授权发布，其他媒体转载或引用须经《美国外科病理学杂志》同意 ，否则追究法律责任；所有文章仅供公益交流，不代表本站立场。欢迎提供素材、资料等，投稿邮箱： tougao@91360.com，一经采纳将给予稿费】
©2018 Wolters Kluwer Health
The material is published by Wolters Kluwer Health with the permission of American Journal of Surgical Pathology.No part of this publication may be reproduced in any form,stored in a retrieval system or transmitted in any form,by any means,without prior written permission from Wolters Kluwer Health.Opinions expressed by the authors and advertisers are not necessarily those of the American Journal of Surgical Pathology, its affiliates,or of the Publisher.The American Journal of Surgical Pathology,its affiliates,and the Publisher disclaim any liability to any party for the accuracy,completeness,efficacy,or availability of the material contained in this publication (including drug dosages) or for any damages arising out of the use or non-use of any of the material contained in this publication.
Although advertising material is expected to conform to ethical (medical) standards,inclusion in this publication does not constitute a guarantee or endorsement of the quality or value of such product or of the claims made of it by its manufacturer.
【本文经《美国外科病理学杂志》授权发布，其他媒体转载或引用须经《美国外科病理学杂志》同意 ，否则追究法律责任；所有文章仅供公益交流，不代表本站立场。欢迎提供素材、资料等，投稿邮箱： tougao@91360.com，一经采纳将给予稿费】
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