影响胃癌根治术后复发转移的因素

Influencing factors of recurrence and metastasis of gastric cancer after radical operation

目的探讨影响胃癌根治术后复发转移的因素。方法回顾性分析302例胃癌患者根治术后肿瘤复发转移的情况,并采用Logistic进行单因素和多因素回归分析。结果本组患者根治术后复发转移率为45.4%,术后2年内复发转移率73.7%,2～5年复发转移率21.9%,5年后复发转移率4.4%;单一复发转移占83.2%,多部位复发转移占16.8%。单因素分析显示胃癌根治术后复发转移与肿瘤大小、原发灶部位、癌细胞分化程度、大体分型、癌细胞浸润深度、辅助化疗、术后病理、TNM分期有关,经过多因素回归分析后显示肿瘤大小、辅助化疗、TNM分期为胃癌根治术后复发转移的独立因素。结论胃癌根治术后复发转移大部分在术后2年内,以单一复发转移为主;肿瘤大小、TNM分期及辅助化疗为胃癌根治术后复发转移的独立影响因素。

Objective:To explore the influencing factors of recurrence and metastasis of gastric cancer af-ter radical operation.Methods:We retrospectively analyzed the recurrence and metastasis status of 302 pa-tients with gastric cancer undergone the radical gastrectomy.Logistic multiple regression was used for uni-variate regression analysis or multivariate regression analysis.Results:The total rate of recurrence and metastasis was 45.4%,the rate was 73.7%(during 2 years),21.9%(2～5 years)and 4.4%(more than 5 years) respectively.The rate of the single recurrence and metastasis was 83.2%,and the multiple metastases was 16.8%.The result of univariate regression analysis indicated that there were many influencing factors of re-currence and metastasis of gastric cancer after radical operation,such as the size of tumor,primary site,the differential level of cancer cells,gross type classification,the penetration depth of cancer cells,adju-vant chemotherapy,postoperative pathology and TNM staging.The results of multivariate regression analysis demonstrated that the size of tumor,adjuvant chemotherapy and TNM staging were the independent influ-encing factors.Conclusion:Most recurrence or metastasis among gastric cancer after radical gastrectomy oc-curred during two years.The size of tumor,TNM staging and adjuvant chemotherapy were the independent influencing factors.