胃癌No.14v组淋巴结转移的危险因素及预后分析

Risk factors and prognostic analysis of lymph node metastasis in No.14v group in gastric cancer

目的探讨胃癌No.14v组淋巴结转移的危险因素及对预后的影响。方法回顾性分析72例行胃癌D2根治术+No.14v组淋巴结清扫患者的临床资料。采用Logistic回归分析影响No.14v组淋巴结转移的因素,Cox回归分析No.14v组淋巴结转移与预后的关系。结果No.14v组淋巴结转移率为25.0%(18/72)。Logistic回归分析显示,Borromann分型Ⅲ~Ⅳ型(OR=81.508,95%CI:4.805~1382.635,P=0.002)、远处转移(OR=11.494,95%CI:1.085~121.723,P=0.043)和TNM分期Ⅲ~Ⅳ期(OR=8.101,95%CI:1.355~48.437,P=0.005)是影响No.14v组淋巴结转移的独立危险因素。No.14v组淋巴结转移组患者的中位生存时间低于非转移组(22个月vs 33个月,χ~2=22.737,P<0.001);多因素Cox回归分析显示,No.14v组淋巴结转移是影响患者总生存期的独立影响因素(HR=2.881,95%CI:1.222~6.793,P=0.016)。结论No.14v组淋巴结转移的胃癌患者预后较差,Borromann分型Ⅲ~Ⅳ型、远处转移及TNM分期Ⅲ~Ⅳ期是No.14v组淋巴结转移的独立危险因素。

Objective To investigate the risk factors and to perform prognostic analysis of lymph node metastasis in the No.14 v group in gastric cancer. Methods The clinical data of 72 gastric cancer patients who underwent radical gastrectomy with lymph node in the No.14 v group dissection were analyzed retrospectively. Logistic regression was used to analyze the factors affecting lymph node metastasis in the No.14 v group,Cox regression was used to analyze the relationship between lymph node metastasis in the No.14 v group and prognosis. Results The lymph node metastasis rate in the No.14 v group was 25.0%(18/72). Logistic regression analysis showed that Borromann classification Ⅲ-Ⅳ(OR=81.508,95%CI:4.805-1 382.635,P=0.002),distant metastasis(OR=11.494,95%CI:1.085-121.723,P=0.043),and TNM stages Ⅲ-Ⅳ(OR = 8.101,95%CI :1.355-48.437,P= 0.005) were independent risk factors affecting lymph node metastasis in the No.14 v group. The median overall survival of patients with lymph node metastasis in the No.14 v group was lower than that in the non-metastatic group(22 months vs 33 months,χ~2= 22.737,P<0.001). Multivariate Cox regression analysis showed that lymph node metastasis in the No.14 v group was an independent influencing factor for the overall survival of patients(HR=2.881,95%CI:1.222-6.793,P=0.016). Conclusions Patients with lymph node metastasis in the No.14 v group have a poor prognosis in gastric cancer,and the independent risk factors for lymph node metastasis in the No.14 v group include Borromann classificationⅢ-Ⅳ,distant metastasis,and TNM stage Ⅲ-Ⅳ.