摘要
目的探讨早期胃癌人表皮生长因子受体2(HER2)状态等临床病理特征与淋巴结转移的相关性及建立早期胃癌淋巴结转移风险预测模型。方法收集157例行根治性胃切除术的早期胃癌患者的HER2状态等临床病理资料。对上述资料进行分析并建立早期胃癌淋巴结转移风险预测模型。结果157例早期胃癌患者中31例有淋巴结转移,转移率为19.7%。女性患者、HER2 IHC(3+)、浸润至黏膜下层、未分化型、有脉管癌栓的在淋巴结转移中占比较大(P<0.05)。HER2 IHC(3+)、浸润至黏膜下层、未分化型、有脉管癌栓是早期胃癌淋巴结转移的独立危险因素(P<0.05)。根据上述分析结果分别建立纳入HER2状态与未纳入HER2状态的早期胃癌淋巴结转移风险预测模型,得出受试者工作特征(ROC)曲线下面积(AUC)分别为0.800和0.759。肿瘤为分化型的在HER2 IHC(3+)中占比较大(P<0.05)。结论HER2 IHC(3+)、浸润至黏膜下层、未分化型、有脉管癌栓是早期胃癌淋巴结转移的独立危险因素,根据此建立的早期胃癌淋巴结转移风险预测模型(纳入HER2状态)具有良好的敏感度和特异度,可以为预测早期胃癌淋巴结转移风险提供参考。
Objective To investigate the correlation between clinicopathologic features like human epidermal growth factor receptor type 2(HER2) status and lymph node metastasis, meanwhile, to establish a prediction model for the risk of lymph node metastasis in early gastric cancer. Methods Multiple data of 157 patients who underwent early gastric cancer radical gastrectomy were involved and analyzed. Further, the risk prediction model was established for lymph node metastasis of early gastric cancer. Results Among these 157 patients, 31 cases were reported lymph node metastasis, with a rate of 19.7%. Analysis showed that female patients, HER2 IHC(3+), infiltrating into submucosa, poor degree of differentiation and vascular invasion accounted for a large proportion in lymph node metastasis(P<0.05). Analysis also showed that HER2 IHC(3+), infiltrating into submucosa, poor degree of differentiation and vascular invasion were independent risk factors for lymph node metastasis in early gastric cancer(P<0.05). According to the above analysis results, the prediction models for lymph node metastasis risk of early gastric cancer were established respectively included or excluded HER2 status, and the area under the ROC curve(AUC) was 0.800 and 0.759, respectively. Meanwhile, differentiated tumor accounted for a large proportion in HER2 IHC(3+)(P<0.05). Conclusion HER2 IHC(3+), infiltrating into submucosa, poor degree of differentiation and vascular invasion were independent risk factors of lymph node metastasis in early gastric cancer. The new established model including HER2 status has good sensitivity and specificity, which may provide a reference for predicting the risk of lymph node metastasis in early gastric cancer.
作者
朱振
张朋悦
蔡永萍
杨叶琴
王晶晶
王亚雷
Zhu Zhen;Zhang Pengyue;Cai Yongping;Yang Yeqin;Wang Jingjing;Wang Yalei(Dept of Gastroenterology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022;Dept of Pathology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)
出处
《安徽医科大学学报》
CAS
北大核心
2022年第7期1151-1155,共5页
Acta Universitatis Medicinalis Anhui
基金
国家重点研发计划(编号:2016YFC1302802)。
