120例贲门癌临床病例分析

Clinical analysis of 120 patients with cardia cancer

①目的比较伴有食管浸润和不伴有食管浸润的贲门癌在临床特点、手术治疗、病理特点和预后的差异,探讨影响生存的因素以指导临床工作。②方法回顾性分析我院普通外科和胸外科收治的贲门癌病例资料。比较两组病例的性别、年龄、确诊时间、症状、肿瘤Borrmann分型、术前肿瘤标记物、有无远处转移、手术方式、消化道重建方式、手术根治度、术后病理资料、生存率等之间的差异并进行统计学分析。③结果贲门癌浸润食管出现吞咽困难者多于贲门癌没有浸润食管者(P=0.020),手术根治度-贲门癌没有浸润食管高于贲门癌浸润食管(P<0.05),肿瘤最大径-贲门癌没有浸润食管小于贲门癌浸润食管(P=0.008),肿瘤浸润层次-贲门癌没有浸润食管超过贲门癌浸润食管(P<0.05),c-erbB-2的表达-贲门癌浸润食管多于贲门癌没有浸润食管(P=0.019)。5年生存率贲门癌浸润食管(35.82%)低于未浸润食管(61.89%)。④结论贲门癌是否浸润食管在症状、c-erbB-2的表达、肿瘤大小、浸润层次方面存在一定的差异,据此选择相应的淋巴结清扫范围有利于提高手术根治度。

Objective To compare the differences in the clinical features,operative manners,pathological characteristics and prognosis between cardia cancer with esophagus infiltration and cardia cancer without esophagus infiltration,and investigate the factors influencing the prognosis to guide the clinical treatment.Methods The data of cardia cancer patients with esophagus infiltration and without esophagus infiltration were retrospectively collected and analyzed from Jan.2004 to Dec.2008 in the department of general surgery and chest surgery,the second people ＇s hospital of Chaohu.The age,gender,the time to make definitive diagnosis,symptoms,Borrmann＇s classification,tumor markers,metastasis,operative manners,reconstruction of alimetary tract,radical operative cure degree,postoperative pathological data and survival rate were compared between two groups.Results The case number of dysphagia in cardia cancer with esophagus infiltration was more than that without esophagus infiltration（P=0.020）,radical operative cure degree without esophagus infiltration was higher than that with esophagus infiltration（P0.05）,the maximum diameter without esophagus infiltration was smaller than that with esophagus infiltration（P=0.008）,the depth of invasion without esophagus infiltration was larger than that with esophagus infiltration（P0.05）,the expression of c-erbB-2 with esophagus infiltration was higher than that without esophagus infiltration（P=0.019）,5 year survival rate with esophagus infiltration（35.82%）was lower than that without esophagus infiltration（61.89%）.Conclusion There were differences in the symptoms,c-erbB-2 expression,tumor size and invasion depth between cardia cancer with esophagus infiltration and without esophagus infiltration,according to this,range of lymphadenectomy was chose to improve radical operative cure degree.