胃癌肝转移患者预后影响因素分析

An Analysis of the Prognostic Factors of Gastric Cancer Patients with Liver Metastasis

[目的]探讨影响胃癌肝转移患者的预后因素。[方法]回顾性分析收治的82例胃癌肝转移患者的临床病理资料,对患者的生存时间进行随访,计算患者的1、2年生存率,及中位生存时间（median survival time,MST）。采用Log-rank检验及Cox比例风险模型对可能影响胃癌肝转移患者生存的影响因素进行单因素及多因素分析。[结果]82例胃癌肝转移患者1、2年生存率分别为46.3%、13.4%,MST为10.9个月。单因素分析结果显示,病理类型、分化程度、肝转移灶数目、化疗、介入治疗、甲胎蛋白（α-fetoprotein,AFP）与胃癌肝转移患者的预后相关;多因素分析结果显示,病理类型（HR=0.470,95%CI：0.256~0.861,P=0.015）、肝转移灶数目（HR=0.413,95%CI：0.233~0.732,P=0.002）是影响胃癌肝转移患者预后的独立危险因素,化疗（HR=2.193,95%CI：1.354~3.551,P=0.001）是胃癌肝转移患者的独立保护因素。[结论]胃癌肝转移患者预后较差,尤其是病理恶性程度较高及肝转移数目较多的患者,化疗可改善患者的预后。

[Objective] To investigate the prognostic factors of gastric cancer patients with liver metastasis. [Methods] The clinical data of 82 gastric cancer patients with hepatic metastasis were analyzed retrospectively. The patients were followed for survival time and calculated 1-,2-year survival rate and median survival time（MST）. The factors influencing the survival of gastric cancer patients with liver metastasis were analyzed by Log-rank test and Cox proportional hazard model. [Results] The 1-,2-year survival rate was 46.3%,13.4%,MST was 10.9 months in all 82 gastric cancer patients with liver metastases. Univariate analysis showed that pathological type,differentiation degree,number of liver metastases,chemotherapy,interventional therapy,and alpha-fetoprotein（AFP） were significant factors for prognosis（P〈0.05）. Multivariate analysis showed that the pathological types（HR =0.470,95% CI：0.256 ~0.861,P =0.015）,and the number of liver metastases（HR =0.413,95% CI：0.233 ~0.732,P =0.002） were the independent risk factors,while chemotherapy（HR=2.193,95%CI：1.354~3.551,P=0.001）were the independent protective factor. [Conclusion] The prognosis of gastric cancer patients with liver metastasis is poor,especially in patients with high malignancy pathological types and numbers of liver metastases,chemotherapy can improve the prognosis of those patients.