56例胃癌患者的外科治疗及预后分析

An analysis of surgical treatment and prognosis in 56 cases with gastric cancer

目的:探讨胃癌患者外科治疗的效果及影响预后的因素。方法:对56例胃癌患者的临床资料进行回顾性分析。56例患者均接受胃癌根治性切除手术,胃远端大部切除毕Ⅰ式吻合术28例,毕Ⅱ式吻合术13例,全胃切除14例,肿瘤局部切除1例,分析不同性别、手术方式、组织学类型、临床分期、浸润深度及有无淋巴结转移、有无术后化疗患者术后1、3年的生存率。结果:术后发生并发症9例;全组患者的1、3年生存率分别为78.6%、48.2%,其中Ⅰ、Ⅱ、Ⅲ、Ⅳ期的1、3年生存率分别为93.3%、80.0%。92.3%、69.2%,72.2%、27.8%,50.0%、10.0%;单因素分析结果显示,胃癌临床分期、浸润深度、淋巴结转移、远处转移、手术方式与预后相关;多因素分析未发现影响预后的独立因素。结论:胃癌患者的预后与肿瘤分期、浸润深度、淋巴结转移、远处转移有关,早期发现、早期诊断和治疗胃癌是提高患者术后生存率的关键。

Objective： To assess the prognosis of patient with gastric cancer after gastrectomy. Methods： Clinical data of 56 cases after gastrectomy from 1999 to 2002 were analyzed retrospectively. All patients underwent gastrectomy, including distal stomach resection and Billroth Ⅰ inosculated （28）, distal stomach resection and Billroth Ⅱ inosculated （13）, Total gastrectomy （14）, and local gastrectomy （1）. To analyze the 1- and 3- year survival rates affect by different sex, operative type, histological type, clinical stage, inflict depth, lymph node metastasis and postoperative chemotherapy. Results： The overall 1- and 3- year survival rates were 78.6% and 48.2% for the whole group. And the different clinical stage Ⅰ, Ⅱ, Ⅲ, Ⅳ were 93.3%, 80.0%, 92.3%, 69.2%, 72.2%, 27.8%, 50.0%, 10.0% respectively. Univariate analysis showed that the predictors of survival were clinical stage, inflict depth, lymph node metastasis, distant metastasis and operative type. Multivariate analysis showed no independent factors. Conclusion： Early diagnosis and early treatment of gastric cancer can achieve maximal improvement of survival rate and quality of life.