974例胃癌患者预后因素分析

An Analysis of Prognostic Factors in 974 Patients with Gastric Cancer

目的:回顾性分析974例胃癌患者的资料,探讨影响胃癌生存的预后因素。方法:采用回顾性调查研究方法,分析974例胃癌患者病历资料。采用Kaplan-Meier方法进行生存率分析,Log-rank检验进行单因素分析,COX比例风险模型分析胃癌预后的相关因素。结果:患者的性别、发病年龄、吸烟史、饮酒史、肿瘤家族史、肿瘤类型、是否化疗等7个因素与胃癌预后无明显相关性;胃癌肿瘤侵袭范围、病理类型、组织分化程度、是否转移、临床TNM分期、手术方式和是否接受中药治疗等7个因素是其预后的独立影响因素(P<0.05),其中肿瘤局部浸润范围、肿瘤病理分型、组织分化程度、伴有转移、临床TNM分期是患者的危险因素,而接受根治性手术和中医药治疗是胃癌预后的保护性因素。结论:肿瘤局部浸润范围广、肿瘤组织学分型复杂、组织分化差、伴有转移、临床分期晚的胃癌患者预后较差;接受根治性手术和选择中医药治疗可改善其预后。

Objective： To explore the prognostic factors that influenced the survival of gastric cancer through the retrospective analysis of 974 patients with gastric cancer. Methods： In this study, a total of 974 cases of gastric cancer patients were collected. This study used retrospective study method, Kaplan-Meier method for sur- vival rate analysis, Log-rank test for single factor analysis, COX＇s proportional hazards regression model for prognostic factors analysis of gastric cancer. Results： There were no significant correlations between the 7 factors, including sex, age, smoking history, history of alcohol intake, family history of cancer, tumor type, chemotherapy. The 7 factors of tumor invasion range, pathological type, degree of histological differentiation, metastasized or not, TNM stage, surgical mode and whether used TCM treatment are independent prognostic factors in patients with gastric cancer （P〈0.05）. Among them, tumor invasion range, pathological type, degree of histological differ- entiation, metastasized, TNM stage are risk factors for prognosis of gastric cancer, and received radical surgery and TCM treatment are the protective factor for the prognosis of gastric cancer. Conclusion： The patients with a wide range of local invasion of the tumor, complex tumor histological type, poor degree of histological differenti- ation, metastasis, late clinical stage have a poorer prognosis. Accepted radical surgery and TCM treatment can improve the prognosis of gastric cancer.