Publication: Diameter of involved nerves is a valuable
prognostic factor for gastric cancer
Authors
Zhou, Zhi-hua ; Zhang, Jian-dong ; Zhao, Hai-Bin ; Wu, Yao-yi
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Publisher
F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología
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DOI
https://doi.org/10.14670/HH-11-609
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info:eu-repo/semantics/article
Description
Abstract
The prognostic role of perineural invasion
(PNI) in gastric cancer remains unclear. We
hypothesized that the diameter of the tumor-involved
nerves might be a useful indicator for prognosis. By
labeling nerves and cancer cells in 204 cases of gastric
cancer with single or double immunochemistry, we
found that 146 cases were PNI positive and that 58 were
PNI negative. For each case with PNI, the maximum
diameter of the involved nerve was measured
microscopically. Then, we correlated this parameter with
the patients’ 5-year overall survival, and receiver
operating curves were used to determine the cutoff
value. We found that the optimal cutoff value for
predicting 5-year survival was 65 µm (sensitivity 76.9%,
specificity 70.0%). Next, all 204 patients were classified
into two groups as follows: Group A, PNI-positive cases
in which the largest involved nerves were ≥65 µm in
diameter (110 cases); Group B, PNI-positive cases in
which the largest involved nerves were <65 µm and all
PNI-negative cases (94 cases). Compared with Group A,
Group B had a better 5-year survival (74.5% vs 27.3%)
and a better 5-year disease-free survival (63.8% vs
23.6%). Multivariate analysis suggested that a ≥65 µm
maximum diameter of the involved nerves was an
independent risk factor for both recurrence (P<0.001)
and gastric cancer-related death (P<0.001) within 5
years. However, if all patients were classified simply
based on whether PNI existed (regardless of the nerve size), this did not provide more information than
traditional clinicopathological variables. In conclusion,
the presence of cancer-involved nerves with a diameter
≥65 µm was a valuable prognostic factor for gastric
cancer.
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Citation
Histology and histopathology, Vol. 30, nº 9 (2015)
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