淋巴结转移阴性早期胃癌的临床病理特点及预后分析

Clinicopathological Characteristics and Prognostic Analysis of Early Gastric Cancer without Lymph Node Metastasis

目的:探讨淋巴结转移阴性早期胃癌的临床病理特点及其预后因素,为临床治疗提供理论依据。方法:回顾性分析1983年1月～2003年12月河北医科大学附属邢台人民医院肿瘤外科收治132例淋巴结转移阴性早期胃癌患者的临床病理特征与预后的关系。结果:淋巴结转移阴性与淋巴结转移阳性早期胃癌在肿瘤直径和浸润深度组间有显著性差异(P<0.05)。两者在性别、年龄、家族史、肿瘤数目、肿瘤部位、大体类型和组织学类型分组中有显著性差异(P>0.05)。本组获随访126例,6例失访,随访率为95.5%。3年生存率为91.3%(115/126),5年生存率为84.9%(107/126)。单因素分析经Kaplan-Metier分析筛选出浸润深度与淋巴结转移阴性早期胃癌预后关系密切(P=0.001)。结果表明浸润深度是淋巴结阴性早期胃癌的独立预后因素。黏膜内癌患者的生存率与黏膜下癌者比较,差异有统计学意义(P<0.05)。结论:浸润深度是淋巴结转移阴性早期胃癌的独立预后因素。术前或术中正确评估早期胃癌的淋巴结转移状态是选择合理的治疗方案和改善预后的重要条件。

Objective： To investigate the clinicopathological characteristics and the prognosis of esophageal cancer pa- tients without lymph node metastasis. Methods： We reviewed the clinicopathological data of 132 early gastric cancer patients without lymph node metastasis seen in our hospital between January 1983 and December 2003. Results： Tumor size and depth of invasion were correlated with early gastric cancer without lymph node metastasis （P〈0.05）. No correlations were found between prognosis and tumor location, tumor size, macroscopic type, or histological type （P〉0.05）. Depth of in- vasion was correlated with prognosis （P〈0.05）. The 3- and 5-year survival rates were 91.3% and 84.9%, respectively. Conclusion： Depth of invasion is an independent prognostic factor for early gastric cancer. Precise evaluation of lymph node metastasis before and during surgery is essential for the selection of treatment and improvement of prognosis of early gastric cancer.