残胃癌手术治疗及预后64例相关因素分析

Surgical treatment and prognosis factors analysis on gastric stump carcinoma in 64 cases

目的探讨残胃癌(GSC)的临床特点、手术治疗及影响预后的相关因素。方法回顾性分析64例残胃癌患者的临床资料,并进行随访,用Kaplan-Meier法进行生存分析,用Cox回归模型进行多因素分析。结果残胃癌的临床表现缺乏特异性,但多发于吻合口(50%);远端胃大部切除BillrothⅡ式吻合术后发病患者居多(78.1%);原发病中以胃溃疡居多(51.6%);Hp感染率高(59.4%)。64例残胃癌患者中根治性手术切除35例(54.7%),非根治性手术切除29例(45.3%)。结论根治性手术可明显提高残胃癌患者的生存率,肿瘤组织分化程度、淋巴结转移、TNM分期、手术根治、腹膜种植和肝转移是影响残胃癌患者预后的独立因素。

Objective To explore the clinical chaxacteristics, surgical treatment and prognosis factors in gastric stump carcinoma. Methods The clinical data of 64 GSC patients were retrospectively analyzed, and prognosis data were collected by follow-up. Patient＇s survival was analyzed by Kaplan-Meier method, the prognosis was analyzed by Cox multivariate regression model. Results The clinical features of GRC were nonspecific, but the site of GRC lesion was most commonly located in the anastomotic region（50%）; The genesis of GRC after Billroth Ⅱ was major（78.1%）; Gastric ulcer was major in primary disease （51.6% ）; The infection rate of HP is high （59.4%）. Of the 64 patients, 35 （54.7%） received radical operation, 29 （45.3%）.Conclusion Radical operation may significantly improve the prognosis of GSC. The degree of differentiation of tumor tissue, lymph node metastasis, TNM stage, radical operation, peritoneal seeding and liver metastasis are independent prognosis factors of GSC.