胃癌根治术后患者预后的多因素分析

Analysis of the Prognostic Factors for Patients with Gastric Cancer after Radical Resection

目的:探讨影响胃癌患者根治术预后的因素。方法:回顾性收集289例行胃癌根治性手术患者的临床和病理资料,随访5年,Cox比例风险回归进行生存分析。结果:(1)中位生存时间(45.23±7.58)个月,1、3和5年生存率分别是77.98%、53.64%和41.26%。(2)单因素分析:病理类型、浸润深度、组织分化、TNM分期、淋巴转移、综合治疗等是影响胃癌根治术预后的主要因素(P<0.05);性别、年龄、瘤体部位、瘤体大小、手术方式等与胃癌根治术预后无关(P>0.05)。(3)多因素分析:淋巴转移(RR=3.284)、组织分化(RR=3.168)、浸润深度(RR=3.174)和TNM分期(RR=3.152)是影响预后的独立因素。结论:淋巴转移、组织分化、浸润深度和TNM分期是预后的独立危险因素,可为临床判断胃癌预后提供依据。

Objective： To explore the prognoatic factors of gastric cancer patients after radical resection. Method：The clinical and pathological and 5 years of follow-up data for 289 patients with gastric cancer who underwent radical resection were retrospectively collected. The prognostic factors of gastric cancer patients after radical resection were analyzed by Cox proportional hazards regression model. Result： （ 1 ） The median survival time was （ 45.23 ＋ 7.58 ） months, and the 1, 3 and 5 year survival rates were 77.98%, 53.64% and 41.26%. （ 2 ） Univariate analysis showed that pathological type, depth of invasion, tissue differentiation, TNM stage, lymph node metastasis and comprehensive treatment were the main prognosis factors in these patients （P〈0,05） , However, gender, age, tumor location, tumor size, surgical methods and prognosis of gastric resection were not significant predictors of the prognosis in these patients （ P〉0.05 ） . （ 3 ） Multivariate analysis showed that lymph node metastasis （ RR=3.284 ）, tissue differentiation （ RR=3.168 ）, depth of invasion （ RR=3.174 ）, and TNM stage （ RR=3.152 ） were independent prognostic factors in these patients. Conclusion： Lymph node metastasis, tissue differentiation, depth of invasion, and TNM stage are independent risk factors, and can be helpful for prognosis of gastric cancer patients who received radical resection.