肿瘤家族史与胃癌患者临床病理特征关系的研究

Family history of cancer associated with gastric cancer clinicopathological features

目的:探讨恶性肿瘤家族史(familial history of malignant neoplasm,MN-FH)对胃癌贡献比例及与临床病理特征之间的关系。方法:回顾我院2010年1月-2014年12月间收治的资料齐全的310例胃癌患者的临床病理资料,以有无肿瘤家族史分组,利用SPSS软件统计分析组间临床病理特征关系。结果:96例(31.0%)胃癌患者具有肿瘤家族史,其一级和二级亲属中共有64例(66.7%)具有消化道相关肿瘤,包括食管癌(19.8%)、胃癌(24.0%)、肝癌(6.3%)和结直肠癌(16.7%)。泌尿系肿瘤占12.5%,其他(包括甲状腺癌、乳腺癌、喉癌等)占20.8%。相关性分析显示有无肿瘤家族史在性别及肿瘤发生部位均没有差异(P>0.05)。病理分型显示有MN-FH的胃癌患者以低分化、未分化多见,占60.4%(58/96),无MN-FH占12.6%(27/214),两组相比,P<0.05。而在高、中分化腺癌类型上则相反,有MN-FH胃癌组占39.6%,无MN-FH胃癌组占87.3%,P<0.05。胃癌临床分期显示有MN-FH多以Ⅲ、Ⅳ期为主(73.0%),无MN-FH组以Ⅱ期为主(57.9%),两组相比,P<0.05,具有显著性差异。结论:我院超过1/3的胃癌患者具有阳性MN-FH。其中最常见的MN-FH是消化道肿瘤。MN-FH胃癌具有分化程度低,病理特征恶性程度高特点。对于有家族史人群定期体检非常重要,早诊和早治是提高生存率的关键。

Objective： To investigate the clinicopathological characteristics and familial history of malignant neoplasm（ MN-FH） of gastric cancer patients. Methods： The clinical data of 310 cancer cases in our hospital during January 2010 to December 2014 were analyzed retrospectively. Results： 96 cases（ 31. 0%） patients of gastric cancer had family history of cancer. Of the primary and secondary relatives,64 cases（ 66. 7%） had digestive tract tumors,including esophageal cancer（ 19. 8%）,gastric cancer（ 24. 0%）,liver（ 6. 3%） and colorectal cancer（ 16. 7%）. Urinary system tumor accounted for 12. 5%,other（ including thyroid cancer,breast cancer,laryngeal cancer,etc.） accounted for 20. 8%. The correlation analysis showed that there was no difference between MN-FH and sex,the location of tumor（ P 0. 05）. The pathological typing showed that gastric cancer patients with MN-FH were mainly low differentiation and not differentiation,accounting for 60. 4%（ 58 /96）,no MN-FH accounted for 12. 6%（ 27 /214）,compared with the two group,P 0. 05. While in the high and medium differentiated adenocarcinoma types,there was39. 6% in MN-FH gastric cancer patients,was 7. 3% in no MN-FH gastric cancer group,P 0. 05. The clinical staging of gastric cancer showed that gastric cancer patients with MN-FH were mainly IV stage（ 73. 0%）,and no MN-FH group（ 57. 9%）,P 0. 05. Conclusion： Over 1 /3 in our hospital patients of gastric cancer had a positive MN-FH. The most common forms is gastrointestinal cancer. MN-FH gastric cancer has the features of low differentiation degree and high pathological features of malignant degree. It is important to early diagnoze and treat patients of gastric cancer with positive MN-FH.