中上部进展期胃癌术后复发的危险因素分析

Risk Factors for Postoperative Recurrence of Proximal Advanced Gastric Cancer

目的探讨中上部进展期胃癌术后复发的相关危险因素,为临床防治提供参考。方法选取作者医院2012-06/2015-06月期间收治的90例中上部进展期胃癌术后患者作为研究对象,所有患者术后定期随访,将其中42例术后肿瘤复发的患者作为复发组,其余48例未发生复发作为未复发组,对两组患者术后复发的相关因素进行单因素和多因素非条件的Logistic回归分析。结果单因素分析结果显示Borrmann分型、浸润深度、阳性淋巴结个数、胃切除范围、手术方式、术后腹腔热灌注化疗、Her-2阳性表达、脉管侵犯、分化程度、Ki67阳性表达与中上部进展期胃癌术后复发组间比较差异有统计学意义(P<0.05);多因素非条件的Logistic回归分析显示Borrmann分型、浸润深度、阳性淋巴结个数、分化程度、Ki67阳性表达是中上部进展期胃癌复发的独立危险因素,其中术后腹腔热灌注化疗是其保护因素。结论对影响中上部进展期胃癌术后复发的相关危险因素积极进行干预,对预防中上部进展期胃癌术后复发有重要的临床意义。

Objective To explore the risk factors for postoperative recurrence of proximal advanced gastric cancer, and provide the reference for clinic. Methods A total of 90 patients with postoperative proximal gastric cancer were ana- lyzed from June 2012 to June 2015. All patients were followed up regularly,42 of them with recurrent cancer as recurrence group, the rest as non-recurrence group. The relevant factors of two groups were conducted by single factor and non-condi- tional logistic regression analysis. Results Single factor analysis results showed that Borrmann type,infiltration depth, number of positive lymph node, excision extension of gastrectomy, surgical method, postoperative intraperitoneal hyper- thermic perfusion chemotherapy, positive expression of Her-2, vascular invasion, differentiated degree, positive expression of Ki67 were closely related to postoperative recurrence （P〈0. 05）. Multiple factors unconditioned logistic regression a- nalysis showed that Borrmann type,infiltration depth, number of positive lymph nodes, differentiated degree, positive ex- pression of Ki67 were the risk factors for postoperative recurrence of proximal advanced gastric cancer, and postoperative intraperitoneal hyperthermic perfusion chemotherapy was the protective factor. Conclusion Positive intervention measures in postoperative recurrence of proximal advanced gastric cancer have a great clinical significance for the prevention of post operative recurrence.