原发性胃癌手术后肝脏转移的相关因素研究

Related factors of primary gastric cancer after surgery in patients with liver metastasis

目的:探究原发性胃癌患者手术后肝脏转移的相关因素。方法:选取2013年6月—2014年6月收治的100例原发性胃癌患者为研究对象,所有患者均采用胃癌根治术进行治疗,回顾性分析患者的临床资料,对手术后肝脏转移的相关因素进行分析。结果:经CT检查诊断100例患者中,术后3个月内9例患者表现出疼痛、黄疸、腹胀、腹水等临床症状,经CT检查10例患者发生肝脏转移;术后12个月内21例患者表现出疼痛、黄疸、腹胀、腹水等临床症状,经CT检查21例患者均发生肝脏转移。单因素分析结果显示,年龄、Bormann分型、原发病灶直径、浸润深度、脉管浸润、淋巴转移、术前血清CEA值、手术方法、术后辅助化疗与原发性胃癌患者手术后肝脏转移有密切的相关性(P<0.05)。多因素Logistic分析结果显示,原发病灶直径、脉管浸润、淋巴转移、术前血清CEA值、术后辅助化疗为原发性胃癌患者手术后发生肝脏转移的独立危险因素(P<0.05)。结论:临床上应当加强对原发病灶直径>5 cm、有脉管浸润和淋巴结转移、术前血清CEA值>5 ng/mL、术后未进行辅助化疗的原发性胃癌患者进行胃癌根治术的术后监测,预防肝脏转移的发生。

Objective： To explore the related factors in patients with primary gastric surgery of liver metastases. Methods： Selected June 2013 -100 cases of primary gastric cancer patients during June 2014 in our hospital for the study, all patients were treated with radical gastrectomy for treatment, clinical data were retrospectively analyzed patients with primary gastric cancer factors re- lated liver metastasis were analyzed after surgery. Results： The CT examination of 100 patients af- ter diagnosis, 21 patients liver metastasis surgery within 3 months after the 9 patients show clinical symptoms of pain, jaundice, abdominal distension, ascites, etc., by CT examination in 10 patients liver metastases occur. Within 12 months after the 21 patients show clinical symptoms of pain, jaundice, abdominal distension, ascites, CT examination of 21 patients developed hepatic metas- tases. Univariate analysis showed that age, Bormann type, primary tumor diameter, depth of invasion, vascular invasion, lymph node metastasis, preoperative serum CEA value, surgical methods, postoperative adjuvant chemotherapy after surgery in patients with liver metastases of gastric carcinoma there is a close correlation （P 〈 0.05）. Logistic multivariate analysis showed that the primary lesion diameter, vascular invasion, lymph node metastasis, preoperative serum CEA value, indepen- dent risk factors for liver metastasis（P〈 0.05） postoperative adjuvant chemotherapy in patients with primary gastric cancer after surgery. Conclusion： Postoperative clinical shall strengthen the primary lesion diameter 〉 5 cm, there is vascular invasion and lymph node metastasis, preoperative serum CEA value 〉 5 ng/mL, no postoperative adjuvant chemotherapy for patients with primary gastric cancer were performed gastrectomy surveillance, prevention of liver metastasis.