早期与中晚期贲门腺癌患者术后预后影响因素

Influencing factors of postoperation prognosis of early and advanced gastric cardiac adenocarcinoma patients

目的:探讨早期与中晚期贲门腺癌(GCA)患者的术后预后影响因素。方法:从河南省食管癌重点开放实验室50万例食管癌和贲门癌临床信息数据库中收集5 596例GCA患者的资料。其中男4 321例,女1 275例;早、中、晚期患者分别有335、5 168和93例。患者均接受根治术治疗。结果:Cox分析结果显示,确诊年龄≥60岁(HR=3. 069,95%CI=1. 167～5. 625)、有癌栓(HR=3. 137,95%CI=1. 063～9. 253)是早期GCA患者术后预后的危险因素;男性(HR=1. 090,95%CI=1. 002～1. 185)、确诊年龄≥60岁(HR=1. 409,95%CI=1. 312～1. 531)、有癌栓(HR=1. 299,95%CI=1. 167～1. 446)、溃疡浸润型(HR=1. 260,95%CI=1. 108～1. 432)、中低分化(HR=1. 167,95%CI=1. 103～1. 344)、浸润程度深(HR=1. 502,95%CI=1. 350～1. 671)是中晚期GCA患者术后预后的危险因素。结论:确诊年龄≥60岁、有癌栓是所有病期GCA患者术后预后的独立危险因素,而男性、浸润溃疡型、低分化、浸润程度深是中晚期患者术后预后的独立危险因素。

Aim: To investigate the influencing factors of postoperation prognosis of early and advanced gastric cardiac adenocarcinoma( GCA) patients. Methods: The data of 5 596 patients with GCA from the clinical information database of500 000 cases of esophageal and gastric cardia carcinoma of Henan key laboratory of esophageal cancer research were collected. Among them,4 321 cases were male,1 275 cases were female;335 patients were early stage,5 168 patients were advanced stage and 93 patients were terminal stage. All the patients were treated with radical resection. Results: The Cox results showed age at diagnosis≥60 years( HR = 3. 069,95% CI = 1. 167-5. 625),and cancer thrombosis( HR = 3. 137,95% CI = 1. 063-9. 253) were independent influencing factors for prognosis of early GCA patients;male( HR = 1. 090,95% CI = 1. 002-1. 185),age at diagnosis≥60 years( HR = 1. 409,95% CI = 1. 312-1. 531),cancer thrombosis( HR =1. 299,95% CI = 1. 167-1. 446),invasive ulcer type( HR = 1. 260,95% CI = 1. 108-1. 432),median or low differentiation degree( HR = 1. 167,95% CI = 1. 103-1. 344),deep infiltration degree( HR = 1. 502,95% CI = 1. 350-1. 167) were independent influencing factors for prognosis of patients with advanced GCA. Conclusion: Age at diagnosis≥60 years and cancer thrombosis are independent risk factors for GCA prognosis;male,invasive ulcer type,poor differentiation and deep infiltration degree are only independent risk factors for the patients with advanced GCA.