【摘要】 目的探讨进展期胃癌新辅助化疗肿瘤退缩分级(tumor regression grade,TRG; Mandard标准)相关的临床病理特征以及TRG分级的新辅助化疗疗效评估价值。方法回顾性收集行新辅助化疗联合根治性手术治疗的胃癌患者120例,分析影响TRG分级的临床病理特征以及实体肿瘤治疗反应评估标准(response evaluation criteria in solid tumor 1. 1,RECIST1. 1)与肿瘤TRG分级的相关性。结果 120例胃癌患者中36例为TRG 1～2级,44例为TRG 3级,40例为TRG 4～5级。TRG分级在肿瘤大小、组织分型、分化程度、脉管癌栓或神经侵犯、Lauren分型、Borrmann分型、侵及深度(p T)及病理分期(p TNM)方面比较,差异均具有统计学意义(均P <0. 05)。多因素分析显示,侵及深度(p T)与TRG分级相关(P=0. 028)。在评价新辅助化疗疗效方面,RECIST1. 1标准与TRG分级有相关性(P <0. 01)和较好的一致性(1～3级对应CR/PR,4～5级对应PD/SD,Kappa值为0. 472,P <0. 01)。TRG分级预测RECIST1. 1标准评估化疗疗效(1～3级对应CR/PR,4～5级对应PD/SD)的敏感度为87. 0%,特异度为58. 8%。结论胃癌新辅助化疗TRG分级与肿瘤大小、组织分型、分化程度、脉管癌栓或神经侵犯、Lauren分型、Borrmann分型、侵及深度及病理分期有关。评估新辅助化疗疗效,RECIST标准与TRG分级具有相关性及中、高度一致性,TRG可作为评估胃癌新辅助化疗疗效的一项参考指标。更多还原

【Abstract】 Objective To explore the clinicopathological factors associated with tumor regression grade( TRG) for advanced gastric cancer after neoadjuvant chemotherapy,and the value of TRG on the effect of neoadjuvant chemotherapy.Methods Totally 120 gastric cancer patients treated with radical gastrectomy combined with neoadjuvant chemotherapy were retrospectively collected. The clinicopathological factors associated with TRG and the relationship between TRG and response evaluation criteria in solid tumor 1. 1( RECIST1. 1) in assessing treatment effect of neoadjuvant chemotherapy were analyzed. Results Of the 120 gastric cancer patients,36 patients were TRG of grade 1-2,44 were grade 3,and 40 were grade 4-5. TRG was statistically significant in terms of tumor size,tissue type,degree of differentiation,nerve invasion or vascular tumor thrombus,Lauren classification,Borrmann classification,depth of invasion( p T stage),and pathological stage( p TNM)( all P < 0. 05). Multivariate analysis showed that the depth of invasion( p T) was associated with TRG( P = 0. 028). TRG was related to RECIST1. 1 in terms of assessing treatment outcome of neoadjuvant chemotherapy( P < 0. 01). Furthermore,the results of TRG were in consistent with the findings of RECIST1. 1 to a certain extent( matching grade 1-3 with CR/PR; matching grade 4-5 with PD/SD,Kappa = 0. 472,P < 0. 01). TRG predicted the sensitivity of RECIST1. 1 for the evaluation of neoadjuvant chemotherapy with a sensitivity of 87. 0% and a specificity of 58. 8%,respectively. Conclusions TRG is related to tumor size,tissue type,degree of differentiation,nerve invasion or vascular tumor thrombus,Lauren classification,Borrmann classification,depth of invasion( p T stage),and pathological stage( p TNM). TRG is also correlated to RECIST1. 1 in assessing treatment outcome of neoadjuvant chemotherapy. TRG can be used as a reference for assessing the efficacy of neoadjuvant chemotherapy for gastric cancer.更多还原