中西医结合治疗Ⅳ期胃癌临床回顾性研究

A Clinical Retrospective Study on Combined Treatment of Integrative Medicine for Stage IV Gastric Cancer

目的:回顾性分析影响Ⅳ期胃癌患者生存预后的相关因素,评价中西医结合治疗对Ⅳ期胃癌患者生存时间的影响。方法:采用回顾性调查研究方法,分析210例Ⅳ期胃癌患者病历资料。用Kaplan-Meier计算生存率,用Log Rank检验法进行单因素分析,用COX回归模型进行多因素分析。结果:Log Rank单因素分析结果显示,手术、性别、年龄、肿瘤家族史、病理分型、腹膜转移、其他转移与Ⅳ期胃癌患者生存预后无明显相关性(P>0.05);中药、发病部位、分化程度、肝转移、远处淋巴结转移、CEA和CA199与Ⅳ期胃癌患者生存预后有相关性(P<0.05)。COX多因素分析结果显示中药、分化程度、CEA、CA199是Ⅳ期胃癌患者生存预后的独立影响因素(P<0.05)。中药是Ⅳ期胃癌患者生存预后的保护因素,低分化、CEA和CA199的高表达是Ⅳ期胃癌患者生存预后的危险因素。结论:中西医结合治疗可延长Ⅳ期胃癌患者生存时间。

Objective:To retrospectively analyze the relevant factors affecting the survival prognosis of stage IV gastric cancer patients and evaluate the impact of combined treatment of traditional Chinese and Western medicine on the survival time of stageⅣgastric cancer patients.Method:A retrospective survey was conducted to analyze the medical records of 210 patients with stageⅣgastric cancer.Calculate survival rate using Kaplan-Meier,conduct univariate analysis using Log Rank test,and conduct multivariate analysis using COX regression model.Result:Log Rank univariate analysis showed that surgery,gender,age,tumor family history,pathological classification,peritoneal metastasis,and other metastases were not significantly correlated with the survival prognosis of stageⅣgastric cancer(P>0.05);Traditional Chinese medicine,site of onset,degree of differentiation,liver metastasis,distant lymph node metastasis,CEA and CA199 are correlated with the survival prognosis of stageⅣgastric cancer(P<0.05).The results of COX multivariate analysis showed that traditional Chinese medicine,degree of differentiation,CEA,and CA199 were independent influencing factors on the survival prognosis of stageⅣgastric cancer patients(P<0.05).Traditional Chinese medicine is a protective factor for the survival and prognosis of stageⅣgastric cancer,while low differentiation,high expression of CEA and CA199 are risk factors for the survival and prognosis of stageⅣgastric cancer.Conclusion:The combination of traditional Chinese and Western medicine treatment can prolong the survival time of patients with stageⅣgastric cancer.