胃癌根治术后肺转移的危险因素分析

Analysis of Risk Factors for Lung Metastasis after Radical Resection of Gastric Cancer

目的分析胃癌根治术后肺转移的危险因素。方法纳入2016年1月至2020年4月在我院收治的胃癌根治术后发生肺转移患者46例(转移组)与术后未发生肺转移125例患者(未转移组),收集患者年龄、发病部位、肿瘤直径、术前TNM分期、病理学类型、浸润深度(T分期)、N分期、术前肿瘤标志物水平、淋巴结清扫程度、术后辅助化疗及其周期、辅助放疗等临床资料,并进行分析。结果单因素组间比较结果显示,胃癌根治术后肺转移与患者年龄、发病部位、肿瘤直径、TNM分期、浸润深度、N分期均有关(P<0.05),而与性别、病理学类型、术前血清肿瘤标志物、淋巴结清扫程度、术后辅助化疗及周期、辅助放疗无关(P>0.05);Logistic回归分析结果显示发病部位、浸润深度、N分期为影响胃癌根治术后肺转移的高风险因素(P<0.05)。结论近端1/3处胃癌、浸润深度T3+T4期及N2-3期为影响胃癌根治术后发生肺转移的独立危险因素,值得临床重点关注。

Objective Analysis of risk factors for lung metastasis after radical resection of gastric cancer.Methods To enroll 46 patients(metastasis group)with lung metastasis after radical gastric cancer who were admitted to our hospital from January 2016 to April 2020.After 125 patients without lung metastasis(non-metastasis group),the patient’s age,location of onset,tumor diameter,preoperative TNM stage,pathological type,depth of invasion(T stage),N stage,preoperative tumor marker level,Clinical data such as the degree of lymph node dissection,postoperative adjuvant chemotherapy and its cycle,adjuvant radiotherapy and other clinical data were analyzed.Results A univariate comparison between the metastatic group and the non-metastatic group showed that lung metastasis after radical gastric cancer surgery was related to the patient’s age and incidence Location,tumor diameter,TNM stage,depth of invasion,N stage are all related(P<0.05),but not related to gender,pathological type,preoperative serum tumor markers,degree of lymph node dissection,postoperative adjuvant chemotherapy and cycle,adjuvant radiotherapy(P>0.05);Logistic regression analysis showed that the location,depth of invasion,and N stage were high-risk factors for lung metastasis after radical resection of gastric cancer(P<0.05).Conclusion proximal 1/3 of gastric cancer,depth of invasion T3+T4 stage and N2-3 stage are independent risk factors that affect the occurrence of lung metastasis after radical gastric cancer surgery,which deserves clinical attention.