Borrmann Ⅰ型胃癌临床病理特点及预后分析

Study on clinicopathological features and prognostic factors in Borrmann type Ⅰ gastric cancer

目的探讨Borrmann Ⅰ型胃癌临床病理特点及预后影响因素。方法收集1980-2006年间在中国医科大学附属第一医院肿瘤外科住院手术的胃癌病人,以大体分型为Borrmann Ⅰ型胃癌者为研究对象(可供分析者共110例),分析其淋巴结转移规律、影响因素及预后。结果 110例病人中男性89例,女性21例。肿瘤直径≥6.0cm63例,团块或巢状生长方式68例。伴淋巴结转移者62例(56.4%),其中N121例、N222例、N319例(7thTNM分期);第Ⅰ站23例、第Ⅱ站34例、第Ⅲ站及以远者共5例(日本JGC分期)。性别及脉管癌栓是影响淋巴结转移的独立因素;性别、浸润深度、根治度和JGC/N分期是影响病人预后的独立因素(P<0.05)。结论 Borrmann Ⅰ型胃癌有其相对独立的临床病理特点,女性病人淋巴结转移率较高,预后相对较差。

Objective To study the clinicopathological features and prognostic factors in Borrmann type I gastric cancer. Methods A retrospective analysis of gastric cancer database from 1980 to 2006, at the Department of Surgical Oncology, First Affiliated Hospital, China Medical University was performed. A total of 110 patients with Borrmann type I were selected, followed up and analyzed. Results Among all the patients, 89 patients were male, 21 patients were female. 63 with tumor size more than 6.0 cm, 68 with massive or nested growth pattern. A total of 62 patients were with positive lymph node metastasis. According to 7th UICC/TNM stage, there were 21 patients in N1, 22 patients in N2, and 19 patients in N3. Twenty-three patients were in level I, 34 in level II, and 5 in leveal III/M based on JGC/N stage. Gender and lymphatic/venous invasion were independent factors on lymph node metastasis by uni- and multivariate analysis. Gender, depth of tumor invasion, radical degree and JGC node classification were the independent prognostic factors（P〈0.05）. Conclusion There are relatively independent clinicopathological features in Borrmann type I gastric cancer. The more lymph node metastasis and poorer prognosis are observed in female patients.