预警症状与胃癌预后的相关性研究

Correlation of alarm symptoms with the outcomes in gastric cancer

目的研究胃癌的预警症状与胃癌预后的相关性。以期对胃癌的诊断及预后判断提供一定的参考。方法统计分析2002年1月至2006年1月确诊的172例胃癌患者的临床资料，其中有预警症状（包括体重减轻、吞咽困难、呕吐、出血、贫血）的患者113例，预警症状时间〉6个月的70例，≤6个月的43例，通过10个月的门诊和电话随访，分析预警症状及症状持续时间与患者生存率的关系。结果172例患者的3年和5年生存率分别为40．12％（69／172）和1919％（33／172）。有预警症状者的3年生存率为30．09％（34／113），其中体重减轻、吞咽困难、呕吐、出血、贫血患者的3年生存率分别为29．35％（27／92）、0％（0／9）、O％（0／10）、38．46％（10／26）、41．38％（12／29）；5年生存率为14．16％（16门13），其中体重减轻、吞咽困难、呕吐、出血、贫血患者的5年生存率分别为12．20％（10／92）、0％（0／9）、O％（O／10）、23．08％（6／26）、24．14％（7／29）。无预警症状者的3年和5年生存率分别为42．37％（25／59）和28．81％（17／59）。预警症状时间〉6个月的患者3年生存率为32．86％（23／70），5年生存率为857％（6／70），≤6个月的患者3年生存率为48．84％（21／43），5年生存率为23．56％（10／43）。有吞咽困难及呕吐者的3年生存率均较无预警症状者明显下降（X^2=4．35、4．94，均P〈O．05）；有预警症状者、体重减轻者较无预警症状者，预警症状时间〉6个月者较≤6个月者，5年生存率均明显下降（X^2=5．37、5．53、4．89，均P〈O．05）。结论预警症状与胃癌患者的预后密切相关，其中体重减轻、吞咽困难及呕吐是有统计学意义的预警症状；症状持续时间与患者的长期生存率无明显关系，但症状持续时间短者其预后明显好于症状持续时间长者。

Objective To investigate the correlation of alarm symptoms with tile outcomes in gastnc cancer. Metnoas One hundred and seventy two patients with gastric cancer were admitted in the hospital from January 2002 to January 2006. A- mong them 113 cases had aiarm symptoms including weight loss, dysphagia, vomit, Gastrointestinal bleeding and anemia; 70 cases had a duration of symptoms over 6 months, 43 cases had a duration less than 6 months. Patients were followed-up with telephone, the survival of patients were analyses with the relevance of alarm symptoms and the duration of alarm symptoms. Re- sults The 3- and 5-year survival rates of atl patients were 40.12%（69/172）and 19.19%（33~172）respectively. The overall 3-year survival rate of patients with alarm symptoms was 30.09%（ 34/113 ）; that with weight loss was 29.35%（ 27/92 ）, with dys- phagia was 0% （0/9）. with vomit was 0% （0/10）, with Gastrointestinal bleedinq was 38.46% （10/26） and with anemia is 41.38%（12/29）. The 3-year survival in patients without alarm symptoms was 42.37%（ 25/59 ）; that with the duration of symptoms over 6 months was 32.86%（ 23/70 }, that with the duration of symptoms tess than 6months was 48.84% （21/43）. The overall 5-year sur- vival rate of patients with alarm symptoms was 14.16% （16/113）, that with weight loss was 12.20% （10/92）, with dysphagia was 0%（0/9）, with vomit was 0%（0/10）, with Gastrointestinal bleeding was 23.08% （6/26） and with anemia was 24.14%（7/29）. The 5-year survival of patients without alarm symptoms was 28.81%（17/59）, that with the duration of symptoms over 6 months was 8.57% （6/70）, and that with the duration of symptoms less than 6months was 23.56%（10/43）. There were significant differences in 5-year survival rate between patients with alarm symptoms or with weight loss and the patients without alarm symptoms, and between patients with the duration of symptoms over 6 months and those with less than 6 months. There were significant differ- ences in 3-year survival rate between patients with dysphagia or vomit and patients without alarm symptoms. Conclusion Alarm symptoms is closely correlated with the outcomes in gastric cancer, and the patients with long duration of symptoms is related to poorer outcomes.