残胃癌的临床病理特征及预后分析

Clinicopathological characteristics and prognosis of remnant gastric cancer

目的 探讨残胃癌的临床病理特征及预后相关因素.方法 回顾性分析1992年3月至2009年9月收治的48例残胃癌患者的临床病理资料.结果 48例患者中.肿瘤位于吻合口32例,位于非吻合口16例.组织学分型：未分化癌2例,低分化腺癌32例,中分化腺癌12例,高分化腺癌2例.病理分期：Ⅰ期5例,Ⅱ期6例,Ⅲ期28例,Ⅳ期9例.根治性切除术患者1、3、5年生存率分别为100.0%、65.4%和32.5%,均显著高于姑息性切除术患者的28.5%、12.2%、0,两者比较差异有统计学意义（P＜0.05）;病理分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期的5年生存率分别为100.0%、66.7%、21.4%和0,各分期之间比较差异均有统计学意义（P＜0.05）.结论 残胃癌病变主要位于吻合口附近,其预后与是否行根治性手术和肿瘤病理分期密切相关.

Objective To investigate the clinicopathological characteristics and prognostic factors of remnant gastric cancer. Method Took a retrospective analysis on the clinical data of 48 patients with remnant gastric cancer from March 1992 to September 2009. Results Of these 48 cases,32 had lesion at anastomotic site and the remaining 16 located in non-anastomotic site. The histological type included 2undifferentiated adenocarcinoma,32 poorly differentiated adenocarcinoma, 12 moderately differentiated adenocarcinoma and 2 well differentiated adenocarcinoma. The pathological stages included stage Ⅰ 5 cases,stage Ⅱ 6 cases,stage Ⅲ 28 cases and stage Ⅳ 9 cases. The 1-year,3-year and 5-year survival rates in patients with the radical treatment were 100.0% ,65.4% and 32.5% respectively, and which were significantly higher than those in patients without radical treatment （28.5% ,12.2% ,0）,the difference was statistically significant （P＜0.05）. The 5-year survival rates of pathological stage Ⅰ , Ⅱ , Ⅲ and Ⅳ were 100.0%,66.7% ,21.4% and 0 respectively, the differences between the various stages were statistically significant （P＜ 0.05）. Conclusion The remnant gastric lesions are mainly located near the anastomosis, the prognosis of remnant gastric cancer is closely related to whether taken radical surgery and the tumor＇s pathological stage.