R0切除且无远处转移胃癌患者上下切缘距离与预后关系研究

Study on the relationship between the distance from the upper and lower resection margin and the gastric cancer patients with R0 resection and no distant metastasis

目的:探讨R0切除且无远处转移胃癌患者上下切缘距离与预后的关系。方法:回顾性分析行胃癌根治术患者281例,分析上下切缘距离与年龄、性别、肿瘤大小、血管侵袭、淋巴结转移、TNM分期、胃癌组织类型、肿瘤位置、手术方式的关系。比较不同上下切缘距离患者生存时间的差异。结果:上切缘距离增大与肿瘤大小>5 cm、TNM分期、肿瘤部位、胃癌组织类型显著相关(P<0.05);下切缘距离与肿瘤大小>5 cm、有血管侵袭、有淋巴结转移、TNM分期、胃癌组织类型显著相关,(P<0.05);上切缘≤3 cm的患者5年随访期中位生存时间48个月,显著的高于上切缘>3 cm的患者的46个月(P<0.001);下切缘≤3 cm的患者5年随访期中位生存时间45个月,显著高于下切缘>3 cm的患者的44个月(P<0.001)。结论:胃癌术后上下切缘与肿瘤大小、TNM分期等因素显著相关,上下切缘>3cm者的生存时间显著低于上下切缘≤5 cm者。

Objective： To investigate the relationship between the distance from the upper and lower resection margin and the gastric cancer patients with R0 resection and no distant metastasis. Methods： Retrospective analysis of 281 patients with gastric cancer in our hospital,the relationship between the age, sex, tumor size, tumor size, vascular invasion, lymph node metastasis, TNM stage, type of gastric cancer,tumor location and operation mode was analyzed. To compare the survival time of patients with different upper and lower margins. Results- The increase of the distance from upper resection margin was significantly related to the tumor size〉5 cm, TNM stage, type of gastric cancer,tumor location, and the difference was statistically significant（P〈0.05）; The distance of lower resection margin was significantly correlated with tumor size〉5cm, vascular invasion, lymph node metastasis and TNM stage, type of gastric cancer, and the difference was statistically significant （P〈0.05）; Themedian survival timein patientsof upper resection margin□3cm with 48 months of the 5-year follow-up period was significantly higher than that in patients of the resection margin〉3cm with 46 months （P〈0.001）. Themedian survival timein patientsof lower resection margin□3cm with 45 months of the 5-year follow-up period was significantly higher than that in patients of the resection margin〉3cm with 44 months （P〈0.001）. Conclusion： Gastric cancer postoperative upper and lower resection margin was significantly related with tumor size, TNM staging factors, and the median survival time of upper and lower resection margin〉5 cm was significantly lower than that of the resection margin3 cm.