影响胃癌预后因素的Cox回归分析

Cox regression analysis of prognostic factors for gastric carcinoma

目的:探讨影响胃癌患者长期生存的预后因素。方法:采用Cox比例风险模型对可能影响胃癌患者预后的11项临床病理参数(包括患者年龄、性别、病理类型、浸润深度、分化程度、浸润的淋巴细胞量、胃旁淋巴结转移数目、癌组织脉管中有无癌栓、肿瘤大小、c-erbB-2表达、TNM分期等),进行单因素和多因素回归分析。结果:Cox单因素回归分析表明胃癌的分化程度、浸润深度、淋巴结转移数、脉管内是否有癌栓、临床分期、肿瘤直径、淋巴细胞浸润量与胃癌的预后有关(P<0.05),而性别、年龄、病理类型、c-erbB-2表达等与预后无关(P>0.05)。但经Cox多因素回归分析,只有肿瘤的直径、脉管内是否有癌栓、淋巴细胞浸润量具有独立的预后意义(P<0.05)。结论:肿块的大小、脉管内是否有癌栓及局部淋巴细胞浸润量可以作为评估胃癌患者预后的独立指标,从而指导胃癌的治疗。

Aim： To study the independent prognosis factors of long-term survival for gastric carcinoma. Methods：Eleven terms of clinicopathologic factors related to prognosis of patients with gastric carcinoma were analyzed by univariate and multivariate Cox regression proportional hazards model. ReSults ： Univariate analysis of Cox proportional hazards regression model revealed that the differentiation of gastric carcinoma, depth of invasion, number of positive lymph nodes, carcinobolt in vessel, TNM stage, tumor size, and number of lymphocytes were relevant to progonsis （ P 〈 0. 05 ）, but sex, age, pathologic type, and expression of c-erbB-2 were not statistically associated with prognosis （P 〉 0. 05 ）. Multivariate analysis showed that tumor size, carcino-bolt in vessel,and number of lymphocytes were independent prognostic factors of gastric carcinoma. Conclusion ： Tumor size, carcino-bolt in vessel,and number of lymphocytes may serve as independent prognostic factors of gastric carcinoma,which can guide how to elect and pratice the therapy programs of gastric carcinoma.