胃癌术后腹膜复发的相关因素分析

Peritoneal Recurrence Following Curative Resection of Gastric Cancer and Its Risk Factors

目的探讨胃癌根治术后腹膜复发的相关因素。方法1998年12月—2008年12月我院共收治了164例胃癌根治术后复发患者,其中腹膜复发64例(39.0%)。采用单因素和多因素Logistic回归分析,对可能影响胃癌术后腹膜复发的临床、病理因素进行分析。结果64例胃癌根治术后腹膜复发患者中,单一腹膜复发者占46.9%(30/64),复合型腹膜复发者占53.1%(34/64);平均复发时间为21.6个月,3年内共有59例患者复发,占复发者总数的92.2%。单因素分析显示,胃癌术后腹膜复发与肿瘤Borrmann分型、浸润深度、阳性淋巴结数目、手术切除方式、术后早期腹腔内化疗有关(P<0.05);多因素Logistic回归分析显示,肿瘤穿透浆膜层、全胃或联合脏器切除及术后早期腹腔内化疗是影响胃癌术后腹膜复发的独立相关因素(P<0.05)。结论肿瘤穿透浆膜、手术切除方式及早期腹腔内化疗是影响胃癌术后腹膜复发的独立因素。

Objective To investigate the clinicopathologic factors related to peritoneal recurrence after curative resection for gastric cancer.Methods The clinicopathologic factors and follow up data of 164 gastric cancer patients with postoperative recurrence,admitted to our hospital from December 1998 to December 2008,included 64 cases of peritoneal recurrence （39.0%）.The clinicopathologic factors possibly influencing postoperative peritoneal recurrence were analyzed by Logistic regression analysis.Results In 64 peritoneal recurrence patients included 30 cases of single peritoneal recurrence （46.9%）,34 compound （53.1%）.The average recurrence time was 21.6 months,recurrence rate within 3 years was 92.2%.Univariate analysis showed that postoperative peritoneal recurrence was related to tumor Borrman typing,depth of invasion,number of positive lymph nodes,surgical approaches,early intraperitoneal chemotherapy,the difference was significant （P〈0.05）.Multivariate Logistic regression analysis showed that tumor penetrating serosa layers,total gastrectomy or joint organ resection,early intraperitoneal chemotherapy were independent relevant factors influencing postoperative peritoneal recurrence （P〈0.05）.Conclusion Tumor penetrating serosa layers,surgical approaches and early intraperitoneal chemotherapy are independent factors impacting peritoneal recurrence after gastric cancer operation.