胃癌病人No.8p淋巴结转移的危险因素及其预后的多因素回归分析

Multivariate regression analysis of the risk factors of No.8p lymph node metastasis and prognosis in patients with gastric cancer

目的:探讨胃癌根治术病人No.8p淋巴结转移的危险因素及其对病人远期预后的影响。方法:对106例行胃癌根治术的病人临床资料进行分析,其中有No.8p淋巴结转移的病人14例,无No.8p淋巴结转移的病人92例,通过多因素logistic回归分析影响病人No.8p淋巴结转移的独立危险因素,Cox回归分析No.8p淋巴结转移对病人远期预后的影响。结果:106例病人中No.8p淋巴结转移率为13.21%。发生No.8p淋巴结转移的胃癌病人在年龄、性别、吸烟、体质量指数及饮酒等特征上差异均无统计学意义(P>0.05),且肿瘤切除部位、血清白蛋白及血红蛋白含量差异亦均无统计学意义(P>0.05),但肿瘤大小≥4 cm、TNM分期较高以及存在联合脏器切除、术中输血的胃癌病人发生No.8p淋巴结转移的概率较高(P<0.05)。多因素logistic回归分析显示,女性、TNM分期、肿瘤大小是胃癌根治术病人发生No.8p淋巴结转移的独立危险因素(P<0.05~P<0.01)。完成随访病人共98例(92.45%),随访时间为22~86个月(中位时间43个月),5年生存率为39.80%。No.8p淋巴结转移病人5年生存率为13.33%低于无No.8p淋巴结转移病人的44.58%(P<0.05)。多因素Cox回归分析结果显示肿瘤大小、TNM分期及No.8p淋巴结转移为影响胃癌根治术病人预后的独立因素(P<0.01)。结论:性别、TNM分期及肿瘤大小是胃癌病人No.8p淋巴结转移的独立危险因素。

Objective:To analyze the risk factors of No.8p lymph metastasis and their effects on long-term prognosis in patients with gastric cancer.Methods:The clinical data of 106 advanced gastric cancer patients treated with radical operation were analyzed.The patients included 14 cases with No.8p lymph metastasis and 92 cases without No.8p lymph metastasis.The independent risk factors affecting the occurrence of No.8p lymph metastasis were analyzed using multivariate logistic regression analysis,and the effects of No.8p lymph metastasis on the long-term prognosis of patients were analyzed using Cox regression analysis.Results:The incidence rate of No.8p lymph metastasis in 106 patients with gastric cancer was 13.21%.Among the patients with No.8p lymph metastasis,there was no statistical significance in the age,gender,smoking,body mass index and drinking(P>0.05),and the differences of the tumor resection site,serum albumin and hemoglobin content were not statistically significant(P>0.05).However,the No.8p lymph metastasis rates in gastric cancer patients with tumor size≥4 cm,higher TNM staging,combined organ resection and intraoperative blood transfusion were higher(P<0.05).The results of multivariate logistic regression analysis showed that the female,TNM staging and tumor size were the independent risk factors of No.8p lymph metastasis in gastric cancer patients treated with radical operation.A total of 98 patients(92.45%)were followed up for 22 to 86 months(median time for 43 months),and the 5-year survival rate was 39.80%.The 5-year survival rate in patients with No.8p lymph metastasis(13.33%)was lower than that in patients without No.8p lymph metastasis(44.58%)(P<0.05).The results of multivariate Cox regression analysis showed that tumor size,TNM staging and No.8p lymph metastasis were the independent factors affecting the prognosis of patients(P<0.01).Conclusions:The sex,TNM staging and tumor size are the independent risk factors of No.8p lymph metastasis in advanced gastric cancer patients.