Abstract:
Primary gastric adenosquamous carcinoma (PGASC) is a rare type of gastric cancer with limited research and poorly understood clinicopathological features. This study investigated the clinicopathological features and outcomes of PGASC. Patients with PGASC from Union Hospital, Tongji Medical College, Huazhong University of Science and Technology and from the published literature were enrolled in this study. Survival curves were generated using the Kaplan-Meier method, and prognostic factors were identified through Cox proportional hazards regression models. This study identified 76 eligible cases of PGASC, with 45 cases from published literature and 31 from our center. The most prevalent symptoms were abdominal pain and dysphagia, with a median age of 62 years (range: 29-84 years). The primary lesions were predominantly in the proximal stomach, with a median tumor size of 6.5 cm (range: 1.5-16.0 cm). Tumor stages II, III, and IV were detected in 12 (16.7%), 43 (59.7%), and 17 (23.6%) patients, respectively. Most tumors were poorly differentiated in both the squamous cell carcinoma (SCC) component and adenocarcinoma (AC) component. The median survival time was 17 months (range: 2-122 months). The 1, 3, and 5-year overall survival (OS) was 60.7%, 31.1%, and 24.1%, respectively. Multivariate analysis revealed that OS was independently predicted by the proportion of SCC component, differentiation of AC component, and tumor stage. PGASC is a rare disease with a poor prognosis. A high proportion of SCC components, low differentiated AC components, and advanced tumor were associated with worse survival in patients with PGASC. Adjuvant therapy did not improve survival time.
摘要:
原发性胃腺鳞癌(PGASC)是一种罕见类型的胃癌,研究有限,临床病理特征了解甚少。这项研究调查了PGASC的临床病理特征和结果。来自协和医院的PGASC患者,同济医学院,华中科技大学和已发表的文献均被纳入本研究。使用Kaplan-Meier方法生成生存曲线,并通过Cox比例风险回归模型确定预后因素。这项研究确定了76例合格的PGASC病例,45例来自已发表文献,31例来自我们中心。最常见的症状是腹痛和吞咽困难,年龄中位数为62岁(范围:29-84岁)。原发灶主要在胃近端,中位肿瘤大小为6.5cm(范围:1.5-16.0cm)。肿瘤II期,III,12例(16.7%)检测到IV,43(59.7%),17名(23.6%)患者,分别。大多数肿瘤在鳞状细胞癌(SCC)成分和腺癌(AC)成分中的分化都很低。中位生存时间为17个月(范围:2-122个月)。1、3和5年总生存率(OS)为60.7%,31.1%,和24.1%,分别。多变量分析表明,OS是由SCC成分比例独立预测的,AC分量的分化,和肿瘤分期。PGASC是一种预后不良的罕见疾病。SCC成分比例很高,低差别化交流分量,和晚期肿瘤与PGASC患者的生存率较差相关。辅助治疗不能改善生存时间。