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胃癌手术治疗与预后的相关因素分析(1)
http://www.100md.com 2009年1月15日 欧阳一鸣 王昆华 龚昆梅 张勇学
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     [摘要] 目的:总结影响胃癌患者手术治疗预后的相关因素,为提高胃癌治愈率提供临床依据。方法:随访分析我院2000~2005年100例胃癌术后患者的临床资料和病理资料,统计术后患者1、3、5年的生存率,并进行统计学单因素及多因素分析。结果:性别对胃癌的预后影响无统计学意义,胃癌的组织学类型、Borrmann分型、肿瘤所处的部位及大小、浸润深度和淋巴结转移度、术后化疗等与胃癌的预后相关 (P<0.01)。结论:胃癌的组织学分型、肿瘤所处的部位及大小、浸润深度和淋巴结转移度以及术后化疗是影响胃癌预后主要的独立危险因子。

    [关键词] 胃癌;手术治疗;预后;相关因素

    [中图分类号] R730.7[文献标识码]A [文章编号]1673-7210(2009)01(b)-028-02

    Relationship of surgical treatment of gastric cancer and prognostic factors

    OUYANG Yi-ming, WANG Kun-hua, GONG Kun-mei, ZHANG Yong-xue

    (The First People's Hospital of Yunnan Province, Kunming650032, China)

    [Abstract] Objective: At present, the gastric cancer is prevalence, and the mortality rate remains high.Despite aggressive treatment approach are taken, the prognosis is not satisfactory.Therefore, analysizing gastric cancer-related factors impacting on the prognosis of patients is important. Methods: 100 gastric cancer patients treated by operation from 2000 to 2005 were collected, and the relationship between prognosis of patients and gastric cancer-related factors were analysized,such as pathological information, postoperative chemotherapy and 1,3,5-year survival rate. Results: Factor of sex had no impact on the prognosis, while other factors such as the type of gastric cancer tissue type, Borrmann type, location and size of tumours, depth of invasion and metastasis, significantly offected the 1,3,5-year survival rate of gastric cancer patients(P<0.01). Conclusion: The tissue type of gastric cancer, location and size of tumor, depth of invasion and metastasis of postoperative chemotherapy may be the key factors which have impact on the prognosis of patients suffered from gastric cancer.

    [Key words] Gastric cancer; Surgical treatment; Prognosis; Related factors

    胃癌是消化系统恶性肿瘤之一,其死亡率居消化系统恶性肿瘤之首位。我国每年死于胃癌的人约有16万[1]。手术治疗仍然是胃癌的主要治疗方式,但随访分析100例胃癌患者术后5年的生存率仍低于50%。现将影响胃癌患者预后的临床因素分析如下:

    1资料与方法

    1.1一般资料

    本组100例中,男58例,女42例,男女比例约为1.4∶1,年龄30~78岁,平均54.6岁,所有患者术前均行胃镜或钡餐检查确诊,术后病理检查确诊为胃癌。其中,早期胃癌21例,进展期胃癌79例。将79例进展期胃癌根据Borrmann分型:Borrmann Ⅰ型32例,Ⅱ型16例,Ⅲ型21例,Ⅳ型10例。组织学类型分型:分化型腺癌(包括乳头状腺癌、高分化管状腺癌、中分化管状腺癌)48例,低分化型腺癌39例(包括印戒细胞癌、黏液腺癌),未分化癌13例。肿瘤的浸润深度(T):T1,20例;T2,36例;T3,40例;T4,4例。淋巴结转移度(N):N0 35例 ......

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