胃癌合并腹水患者预后因素的Cox回归分析

Cox regression analysis of prognosis in patients of gastric carcinoma with malignant ascites

目的探讨影响胃癌合并腹水患者生存的预后因素。方法回顾性分析2011年10月至2013年10月于本院住院治疗且随访资料完整的58例晚期胃癌合并腹水患者的病例资料,采用Kaplan-Meier法进行生存分析,Log-rank法进行单因素分析,Cox比例风险模型进行多因素分析。结果 58例胃癌合并腹水患者的中位生存期为14.0月。单因素分析显示分化程度、浸润深度、肝脏转移情况、KPS评分和治疗方法与患者预后有关,而性别、年龄和腹水量则与预后无关。经Cox多因素回归分析,分化程度、浸润深度、肝脏转移情况、KPS评分及治疗方法是影响胃癌合并腹水患者预后的独立危险因素。结论分化程度、浸润深度、肝脏转移情况、KPS评分及治疗方法是影响胃癌合并腹水患者预后的强相关因素,可作为独立预后指标指导胃癌合并腹水患者的治疗。

Objective To explore the independent prognosis factors of long-term survival for patients of gastric carcinoma with malignant ascites. Methods From December 2011 to October 2013,58 gastric cancer patients with malignant ascites receiving treatment in Xijing Hospital were included in this study. Survival analysis was performed using Kaplan-Meier method. Univariate analysis of prognosis was made by Log-rank method. Multivariable analysis of prognosis was used by Cox proportional hazad regression model. Results The median overall survival was 14. 0 months. In univariate analysis,degree of differentiation,depth of invasion,liver metastasis,KPS score and therapeutic method correlated with the prognosis of the patients of gastric carcinoma with malignant ascites. Multivariate analysis revealed that degree of differentiation,depth of invasion,liver metastasis,KPS score and therapeutic method were independent risk factors of prognosis. Conclusion Degree of differentiation,depth of invasion,liver metastasis,KPS score and therapeutic method may serve as strong factors with gastric carcinoma. Dependent prognostic factors can guide the choice and practice of the therapy for gastric carcinoma with malignant ascites.