影响胃癌根治术术后2年内复发转移的危险因素调查分析

Risk factors investigation analysis on relapse or metastasis after radical excision of gastric cancer within two years

目的探讨影响胃癌根治术术后2年内复发转移的相关危险因素，为临床早期防治提供依据。方法对139例胃癌根治术患者随访2年，2年内依据是否复发分为复发转移组（64例）和未复发转移组（75例），采用单因素、多因素分析方法来筛选早期复发转移的相关危险因素。结果胃癌根治术后早期复发率为46．0％（64／139）；多因素分析结果显示，肿瘤最大直径（OR=3．764）、TNM分期（OR=3．370）、浆膜浸润（OR=8．322）、淋巴结转移（OR=5．219）、阳性淋巴结数（OR=3．226）为胃癌根治术术后早期复发的危险因素，而淋巴结清扫范围（OR=0．236）、术后化疗（OR=0．238）等则为保护因素。结论胃癌根治术术后早期复发率较高，肿瘤越大、TNM分期越高、浆膜浸润、淋巴结转移、阳性淋巴结数越多、淋巴结清扫范围小、术后不化疗均为胃癌术后早期复发的独立危险因素。

Objective To explore the risk factors of early relapse or metastasis after radical excision of gastric cancer, and to provide basis for preventing and treating gastric cancer patients. Methods One hundred and thirty-nine cases of radical excision of gastric cancer were followed by two years. They were divided into relapse metastasis group （64 cases） and non-relapse metastasis group （75 cases）, then single factor and multiple factor analysis methods were used to screen correlated factors of early relapse or metastasis. Results The early relapse rate after radical excision of gastric cancer was 46.0% （64/139）. Multiple factors analysis result showed that maximum diameter of tumor （ OR = 3. 764）, TNM staging （ OR = 3. 370）, serous membrane soakage （ OR= 8. 322 ）, lymphaden metastasis （ OR= 5. 219 ） and positive number of lymphaden were the risk factors of. early relapse after radical excision of gastric cancer, but scavenge scope of lymphaden （ OR = 0. 236） and chemical therapy after operation （ OR = 0. 238） were the protective factors of prognosis. Conclusion The relapse rate after radical excision of gastric cancer is still a little high. These factors such as larger tumor, higher TNM staging, serous membrane soakage, lymphaden metastasis, more positive number of lymphaden, less scavenge scope of lymphaden and without chemical therapy after operation were the in- dependent risk factors of early relapse.