残胃癌41例临床病理特征及生存分析

Clinical-pathological feature and survival of gastric stump carcinoma:an analysis of 41 cases

目的探讨残胃癌(GSC)临床病理特征及影响生存预后的因素。方法追踪并随访中山大学附属第一医院1998年1月至2010年2月的49例GSC患者,分析其临床病理特征及可能影响生存的因素。结果收集有效GSC病例41例(男37例,90.24%),中位发病年龄66岁,初次手术至GSC发生的平均病程为25年,且随年龄的增长有缩短趋势(P=0.003);患者年龄越小,GSC的病理分期越高(P<0.01),组织分化程度越低;多数GSC伴淋巴结的转移(60.98%),5年生存率37.00%。Cox比例风险模型生存分析显示,临床病理分期对生存预后的影响有统计学意义(P=0.004)。结论残胃癌是病理类型相对特殊的一类胃癌,手术根治是提高残胃癌生存预后的关键。

Objective To study the clinical feature and prognosis of gastric stump carcinoma（GSC）.Methods A retrospective study was performed by following GSC cases diagnosed at the First Affiliated Hospital of Sun Yat-sen University between January,1998 and February,2010.The clinical feature and potential prognostic factors were analyzed.Results Forty-one GSC cases（male 37,90.24%） were collected,with a 66-year median age,and an average 25-year interval between primary operation and GSC occurrence,which was negatively correlated with aging（P = 0.003）.The younger of GSC patients,the higher of pathological stages and the lower of the differentiation degrees（P = 0.004）.Most GSC was complicated with lymph nodes metastasis（60.98%）.The 5-year survival rate was 37.00%.Cox proportional hazards model for survival analysis indicated that the clinical-pathological stage significantly affected survival and prognosis.Conclusion Regular gastroscopy is important to improve the quality of life in patients accepted subtotal gastrectomy.