Ⅲ期胃窦癌术后复发转移的相关因素分析

Analysis of relevant factors of recurrence and metastasis following curative surgery for stage Ⅲ gastric antrum cancer

目的:探讨Ⅲ期胃窦癌患者术后复发转移的相关临床病理因素。方法:对新疆医科大学附属肿瘤医院胃肠外科2001～2005治疗的129例Ⅲ期胃窦癌患者行根治术后肿瘤复发转移的情况进行分析。采用Logistic单因素和多因素分析方法,对可能影响Ⅲ期胃窦癌术后复发的9个临床病理因素进行分析。结果:Ⅲ期胃窦癌术后复发率为39.5%。其中局部复发43.1%,远处转移49.0%,两者兼有7.8%。根治术后复发转移的中位时间为15.6个月。术后2年内复发者74.5%、2年后复发者25.5%。单因素分析显示:肿瘤大小、组织学类型、组织学分化、T分级、N分级、肿瘤分期是影响Ⅲ期胃窦癌术后复发转移的危险因素。多因素分析显示,T、N分级是影响Ⅲ期胃窦癌术后总的复发转移以及远处转移的重要因素;而肿瘤分期是局部复发的高危因素。结论:胃癌术后复发大部分发生在术后2年内,以远处转移常见。T、N分级、肿瘤分期是Ⅲ期胃窦癌术后复发转移的独立因素。

Objective： To investigate the related factors for postoperative recurrence and metastasis in patients with stage Ⅲ gastric antrum cancer patients. Methods： From 2001 to 2005, 129 patients with stage gastric antrum cancer were admitted in our hospital and recurrence and metastasis after radical resection of tumors were analyzed. Using Logistic univariate and multivariate analysis methods, 9 clinicopathological factors were analyzed. Results： Stage Ⅲ antral cancer recurrence rate was 39.5%. Among them local recurrence was 43. 1%, distant metastasis 49.0%, and 7.8% both. Recurrence and metastasis after radical resection, the median time was 15. 6 months. 74. 5% of the recurrence was found within 2 years and 25.5% were found in 2 years or later after curative operation. Single-factor regression analysis revealed： tumor size, histological type, histological degree of differentiation and, T classification, N classification, tumor stage were the risk factors of recurrence and metastasis after antral cancer operation. Multivariate. analysis showed：T, N classification were important factors affected distant metastasis, and local recur- rence and metastasis and tumor staging are the risk factors for local recurrence. Conclusion： The majority of gastric cancer recurrence occur in 2 years after surgery and distant metastass is common. T, N classification, tumor staging are independent factors for antral stage Ⅲ cancer recurrence and metastasis.