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Title   진행성 위암의 조직학적 분류에 따른 임상적 특징과 예후 ( Clinical Analysis and Prognosis According to the Histopathologic Type of Advanced Gastric Cancer )
Publicationinfo   1994 Jan; 026(05): 711-722.
Key_word   Gastric cancer, Lauren's and Mings classification, Prognosis
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Abstract   The prognostic significance of histologic ciassifications in patients with advanced gastric cancer has been controversiaL The purpose of this study was to clarify clinical characteristics according to the Lauren's and Ming's classifications and to assess the implication of both classifications as a prognostic factor in advanced gastric cancer. The clinical characteristics accordin& to the histologic classifications were evaluated in 238 patients with advanced gastric cancer who underwent gastrectomy between 1984 and 1993. The authors also investigated whether the Lauren's and Ming's classifications represent a prognostic parameter by log-rank test and Cox proportional hazards models. Two hundred thirty eight patients were classified as intestinal (ll4/238, 48%), diffuse (111/ 238, 47%), and mixed(13/238, 5%), according to Lauren; and as expanding(112/238, 47%) and infiltrative (126/238, 53%), according to Ming. Carcinomas of intestinal type (n= 114) were mostly expanding type (n=101), and carcinomas of diffuse type (n= 111) were mostly infiltrative type (n=105). The percentages of diffuse or in- filtrative type with young age, Borrmann type III or IV, poorly differentiation, and T3-T4 inva- sion were significantly greater than those of intestinal or expanding type, respectively, but no significant differences in types of Laurens or Mings classifications were found with regard to the tumor size, regional 1ymph node metastasis and distant metastasis. The 5-year survival rate of patients with intestinal type (51.4%) was higher than those of patients with mixed type (45.8%) or diffuse type (30.5%). The 5-year survival rate of patient with expanding type (53.9%) was higher than that of patients with infiltrative type(29.6%). Multivariate analysis by Cox proportional hazards models revealed that primary tumor(T), Borrmann type, Lauren's classification, and regional lymph node(N) were significant prognostic factors. These results suggest that there are similarities between Lauren's and Ming's classification in regard of age or sex distribution, Borrmann type, tumor invasion, histologic differentiation, and 5-year survival rate. The combination of WHO histologic type with Lauren's and Mings classifications may provide a fairly complete picture of gastric cancer for prognostic purpose.
저 자   문성하(Sung Ha Moon),신현욱(Hyun Uk Shin),심정원(Jung Weon Shim),안혜경(Hae Kyung Ahn),정경석(Kyung Suk Chung)