{"title":"[胃癌出芽计算方法的预后意义及比较]。","authors":"T V Polushkina, T N Sotnikova, N V Danilova","doi":"10.17116/patol20258703117","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the degree of tumor budding by three methods in gastric cancer and to study its relationship with clinical and morphological characteristics and its impact on overall survival. Choose the best way to determine the tumor budding in gastric cancer.</p><p><strong>Material and methods: </strong>In the surgical material from 172 patients with verified gastric cancer of the tubular histological subtype, tumor budding was identified and counted using three methods: H. Ueno, L. Wang, E. Karamitopolou. Histological samples stained with H&E, as well as using antibodies to the immunohistochemical marker PanCK, were studied. The calculation was carried out in the zone of maximum budding \"hot spot\" with an assessment of 5-10 visual fields and a choice of the average value. The results of calculating the tumor budding were compared with the main clinical and morphological characteristics of gastric cancer using statistical analysis. Overall survival data were obtained for 144 patients.</p><p><strong>Results: </strong>The degree of tumor budding determined by any of the methods is significantly associated with the macroscopic form according to the classification of R. Bormann (<i>p</i>=0.023/p=0.047/<i>p</i>=0.039), morphological type according to the classification of P. Lauren (<i>p</i>=0.001/<i>p</i>=0.000/<i>p</i>=0.001), the presence/absence of signet-ring cells (<i>p</i>=0.008/<i>p</i>=0.008/<i>p</i>=0.017), with the differentiation level (<i>p</i>=0.000/<i>p</i>=0.000/<i>p</i>=0.001), with the presence/absence of tumor emboli in the vascular lumen (<i>p</i>=0.020/<i>p</i>=0.022/<i>p</i>=0.019), TNM classification parameters and the clinical stage of the oncological process (<i>p</i>=0.000/<i>p</i>=0.000/<i>p</i>=0.000). With an increase of tumor budding, the risk of death increases in 1.77/2.12/1.81 the time (<i>p</i>=0.03/<i>p</i>=0.01/<i>p</i>=0.02) set by any of the methods.</p><p><strong>Conclusion: </strong>When using any of the methods for assessing the degree of tumor budding, it has been shown that it is a strong negative prognostic factor in stomach cancer. Although the L. Wang method has the greatest negative predictive value (RR=2.12), we believe that the H. Ueno method should be used, since it is the least labor-intensive.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"87 3","pages":"17-25"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Prognostic significance and comparison of methods for calculating tumor budding in gastric cancer].\",\"authors\":\"T V Polushkina, T N Sotnikova, N V Danilova\",\"doi\":\"10.17116/patol20258703117\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the degree of tumor budding by three methods in gastric cancer and to study its relationship with clinical and morphological characteristics and its impact on overall survival. Choose the best way to determine the tumor budding in gastric cancer.</p><p><strong>Material and methods: </strong>In the surgical material from 172 patients with verified gastric cancer of the tubular histological subtype, tumor budding was identified and counted using three methods: H. Ueno, L. Wang, E. Karamitopolou. Histological samples stained with H&E, as well as using antibodies to the immunohistochemical marker PanCK, were studied. The calculation was carried out in the zone of maximum budding \\\"hot spot\\\" with an assessment of 5-10 visual fields and a choice of the average value. The results of calculating the tumor budding were compared with the main clinical and morphological characteristics of gastric cancer using statistical analysis. Overall survival data were obtained for 144 patients.</p><p><strong>Results: </strong>The degree of tumor budding determined by any of the methods is significantly associated with the macroscopic form according to the classification of R. Bormann (<i>p</i>=0.023/p=0.047/<i>p</i>=0.039), morphological type according to the classification of P. Lauren (<i>p</i>=0.001/<i>p</i>=0.000/<i>p</i>=0.001), the presence/absence of signet-ring cells (<i>p</i>=0.008/<i>p</i>=0.008/<i>p</i>=0.017), with the differentiation level (<i>p</i>=0.000/<i>p</i>=0.000/<i>p</i>=0.001), with the presence/absence of tumor emboli in the vascular lumen (<i>p</i>=0.020/<i>p</i>=0.022/<i>p</i>=0.019), TNM classification parameters and the clinical stage of the oncological process (<i>p</i>=0.000/<i>p</i>=0.000/<i>p</i>=0.000). With an increase of tumor budding, the risk of death increases in 1.77/2.12/1.81 the time (<i>p</i>=0.03/<i>p</i>=0.01/<i>p</i>=0.02) set by any of the methods.</p><p><strong>Conclusion: </strong>When using any of the methods for assessing the degree of tumor budding, it has been shown that it is a strong negative prognostic factor in stomach cancer. Although the L. Wang method has the greatest negative predictive value (RR=2.12), we believe that the H. Ueno method should be used, since it is the least labor-intensive.</p>\",\"PeriodicalId\":8548,\"journal\":{\"name\":\"Arkhiv patologii\",\"volume\":\"87 3\",\"pages\":\"17-25\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arkhiv patologii\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.17116/patol20258703117\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arkhiv patologii","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17116/patol20258703117","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的：评价三种方法在胃癌中的肿瘤出芽程度，探讨其与临床、形态学特征的关系及其对总生存期的影响。选择确定胃癌肿瘤萌芽的最佳方法。材料与方法：在172例经证实的小管组织学亚型胃癌患者的手术材料中，采用H. Ueno、L. Wang、E. Karamitopolou三种方法对肿瘤出芽进行鉴定和计数。用H&E染色的组织学样本，以及免疫组织化学标记物PanCK的抗体，进行了研究。在最大出芽“热点”区域进行计算，评估5-10个视野，选择平均值。计算肿瘤出芽的结果与胃癌的主要临床和形态学特征进行统计学比较。获得144例患者的总体生存数据。结果:肿瘤初露头角的程度取决于任何方法显著相关的宏观形式根据r·鲍曼的分类(p = 0.023 / p = 0.047 / p = 0.039),根据p·劳伦的分类形态类型(p = 0.001 / p = 0.000 / p = 0.001),印戒细胞的存在/没有(p = 0.008 / p = 0.008 / p = 0.017),与分化水平(p = 0.000 / p = 0.000 / p = 0.001),与肿瘤栓子的存在/没有血管腔(p = 0.020 / p = 0.022 / p = 0.019),TNM分型参数与肿瘤过程临床分期（p=0.000/p=0.000/p=0.000）。随着肿瘤出芽的增加，两种方法的死亡风险分别为1.77/2.12/1.81 （p=0.03/p=0.01/p=0.02）。结论：在使用任何一种方法评估肿瘤出芽程度时，已显示其是胃癌预后的一个强有力的负面因素。虽然L. Wang方法的负预测值最大（RR=2.12），但我们认为应该使用H. Ueno方法，因为它的劳动强度最小。
[Prognostic significance and comparison of methods for calculating tumor budding in gastric cancer].
Objective: To evaluate the degree of tumor budding by three methods in gastric cancer and to study its relationship with clinical and morphological characteristics and its impact on overall survival. Choose the best way to determine the tumor budding in gastric cancer.
Material and methods: In the surgical material from 172 patients with verified gastric cancer of the tubular histological subtype, tumor budding was identified and counted using three methods: H. Ueno, L. Wang, E. Karamitopolou. Histological samples stained with H&E, as well as using antibodies to the immunohistochemical marker PanCK, were studied. The calculation was carried out in the zone of maximum budding "hot spot" with an assessment of 5-10 visual fields and a choice of the average value. The results of calculating the tumor budding were compared with the main clinical and morphological characteristics of gastric cancer using statistical analysis. Overall survival data were obtained for 144 patients.
Results: The degree of tumor budding determined by any of the methods is significantly associated with the macroscopic form according to the classification of R. Bormann (p=0.023/p=0.047/p=0.039), morphological type according to the classification of P. Lauren (p=0.001/p=0.000/p=0.001), the presence/absence of signet-ring cells (p=0.008/p=0.008/p=0.017), with the differentiation level (p=0.000/p=0.000/p=0.001), with the presence/absence of tumor emboli in the vascular lumen (p=0.020/p=0.022/p=0.019), TNM classification parameters and the clinical stage of the oncological process (p=0.000/p=0.000/p=0.000). With an increase of tumor budding, the risk of death increases in 1.77/2.12/1.81 the time (p=0.03/p=0.01/p=0.02) set by any of the methods.
Conclusion: When using any of the methods for assessing the degree of tumor budding, it has been shown that it is a strong negative prognostic factor in stomach cancer. Although the L. Wang method has the greatest negative predictive value (RR=2.12), we believe that the H. Ueno method should be used, since it is the least labor-intensive.
期刊介绍：
The journal deals with original investigations on pressing problems of general pathology and pathologic anatomy, newest research methods, major issues of the theory and practice as well as problems of experimental, comparative and geographic pathology. To inform readers latest achievements of Russian and foreign medicine the journal regularly publishes editorial and survey articles, reviews of the most interesting Russian and foreign books on pathologic anatomy, new data on modern methods of investigation (histochemistry, electron microscopy, autoradiography, etc.), about problems of teaching, articles on the history of pathological anatomy development both in Russia and abroad.
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