急症胃癌患者远期预后的随访研究

Follow-up study on long-term prognosis of gastric cancer patients with emergency presentation

目的观察急症起病对胃癌患者远期预后的影响。方法采用回顾性队列研究方法 ,以318例符合条件的胃癌患者为研究对象,随访以电话随访为主,辅以住院随访、门诊随访;生存率计算应用Kaplan-Meier法,组间生存率曲线差异采用log-rank检验。结果 53例(16.7%)患者急症起病,其余265例(83.3%)无急症表现。急症组Ⅳ期患者和姑息性治疗者比例高于非急症组。生存分析表明,急症组的总体生存率明显低于非急症组;经调整病理分期和治疗方法后,两组之间的生存率无显著差异。结论急症起病的胃癌患者生存率较低,但是急症本身并非影响预后的独立因素,较高的病理分期和较低的根治性手术比例是急症胃癌患者预后不良的主要原因。

Objective To observe the influence of emergency presentation on long-term prognosis of patients with gastric cancer. Methods 318 gastric cancer patients meeting the conditions were selected as the research subjects and a retrospective cohort study was carried out. The main form of follow-up was telephone follow-up supplemented by hospitalization and out-patient follow-up. Kaplan-Meier method was used to calculate the survival rate. The difference of survival rate curves between the two groups was inspected by log-rank test. Results 53 cases （16.7%） had emergency onset, and the remaining 265 cases （83.3%） had no emergency presentation. The proportion of patients in 1V stage and those receiving palliative therapy in emergency onset group was higher than those in the non-emergency presentation group. The survival analysis showed that the overall survival rate of the former group was significantly lower than that in the latter group. After the adjustment for pathological stage and treatment methods, the difference in the survival rate between the two groups was not significant. Conclusion Gastric cancer patients with emergency presentation have a lower survival rate. The emergency presentation is not an independent factor influencing the prognosis. Higher pathological stage and lower proportion of radical surgery are the main reasons for the poor prognosis of patients with emergency presentation.