603例胃癌根治术的预后因素分析

Prognostic factor analysis of 603 cases with gastric cancer undergoing radical resection

背景与目的:胃癌在消化道肿瘤的发病率中居首位,总体疗效尚不理想,因此本研究对胃癌患者预后的影响因素做一分析。方法:回顾性分析我院603例行根治性切除术的胃癌患者的临床和病理资料,采用Kaplan-Meier法计算患者的生存率,用Log-rank检验进行单因素分析,应用Cox模型进行预后的多因素分析。结果:性别和年龄对胃癌的预后无显著影响(P>0.05)。胃癌的组织学类型、大体分型(Borrmann分型)、肿瘤所处的部位、浸润深度和淋巴结转移度与胃癌的预后相关(P<0.01)。胃癌的Cox模型多因素分析发现,胃癌的组织学分型、肿瘤所处的部位、浸润深度和淋巴结转移度是影响胃癌预后独立的危险因子。结论:影响胃癌预后的因素较多,以肿瘤的TNM分期与预后的关系最密切,其中淋巴结转移度对预后的影响比肿瘤浸润深度更大。

Background and purpose： Gastric cancer is one of the most common cancers in the alimentary tract, but the overall treatment response was poor. This study was to analyze the prognostic factors of gastric cancer. Methods： 603 patients with gastric cancer who have been pathologically proved and received radical operation were analyzed retrospectively. Gender, age, tumor site, the depth of infiltration and lymph node metastasis of the patients were included in the univariate analysis, significant factors were then entered into a Cox regression analysis. Results： In the univariate analysis, gender and age were found to have no effect on the prognosis（ P 〉 0.05）. Histological type, gross type, tumor site, lymph node metastasis and depth infiltration were related to the prognosis of gastric cancer （P 〈 0.01）. Multivariate Cox model analysis showed that the histological type, tumor site, depth of infiltration and lymph node metastasis rate were the independent prognostic factors for the patients with gastric cancer. Conclusions： There are various factors influencing the prognosis of gastric cancer. Histological type, tumor site, depth of infiltration and lymph node metastasis rate were most important prognostic factors for the patients with gastric cancer.