影响D2根治术治疗进展期胃癌疗效因素分析

Factors Influencing the Efficacy of D2 Radical Gastrectomy for Advanced Gastric Cancer

目的探讨影响进展期胃癌D2根治术后疗效的因素,为改善术后患者的预后及优化胃癌的治疗提供参考。方法回顾性分析2008年1月至2010年1月因进展期胃癌在我院行D2根治术的患者24例,通过查询病历、问询、电话随访获得数据,应用卡方检验、单因素、多因素分析影响胃癌患者根治术后疗效的因素。结果单因素显示患者性别、年龄、出现症状时间、肿瘤部位与疗效无关(P>0.05),肿瘤大小、Borrmann分型、组织学分型、TNM分期、淋巴结转移个数及术后是否辅助化疗与疗效有关(P<0.05)。多因素COX回归分析显示Borrmann分型、TNM分期、淋巴结转移个数、辅助化疗是影响胃癌根治术后疗效的独立因素(P<0.05),其中Borrmann分型、TNM分期、淋巴结转移个数是影响胃癌根治术后疗效的独立的危险因素,术后给予辅助化疗是保护因素。结论影响D2根治术治疗进展期胃癌的危险因素有Borrmann分型、TNM分期、淋巴结转移个数。术后辅助化疗可提高手术治疗效果,改善预后。

Objective To analyze the possible factors affecting D2 radical gastrectomy for advanced gastric cancer. Methods Retrospectlvly analyse 24 advanced gastric cancer patients who underwent D2 radical gastrectomy, the follow up data was get by query medic.al records, inquirer and telephone. Chi-square test, single factor, multi-factor were applied to statistically analyze the factors after surgery. Results The results by single factor showed that gender, age, symptoms of the time and location of the tumor were not related to efficacy （ P 〉 0.05 ） ,tumor size,Bon^nann type, histological type,TNM clinical stage, number of lymph node metastasis were related to chemotherapy and efficacy（P 〈 0.05 ）. Mu｜ti-factor showed that Bomnann type,TNM clini- cal stage, ,umber of lymph node metastasis and chemotherapy were independent factors affecting postoperative effects（ P 〈 0.05 ）. Borrmann type,TNM clinical stage,number of lymph node metastasis were independent risk factors affecting postoperative effects, ehemotherapy after surgery was protective factor. Conclusion Borrmann type,TNM clinical stage,number of lymph node metas- tasis are the independent risk factors for the patients with gastric cancer after radical resection, and chemotherapy after surgery could improve surgical results and prognosis.