进展期胃癌生长方式对转移方式及预后的影响

Influence of Metastasis Pattern and Prognosis of Advanced Gastric Cancer by Growth Pattern

目的 :研究胃进展期癌在胃壁内生长方式对转移方式及预后的影响。方法 :根据Ming氏分型将 180例胃癌分为膨胀型癌及浸润型癌 ;分析不同浸润深度的膨胀型癌及浸润型癌的转移方式 (血行、淋巴行及种植 ) ,比较其 5年生存率及预后。结果 :1)浸润至肌层及以内 4 7例 :膨胀型癌血行转移率明显比浸润型癌高 ,P <0 0 1;5年生存率比浸润型癌低 ,P <0 0 5 ;2 )浸润至浆膜及浆膜外 133例 :浸润型癌淋巴结转移率比膨胀型癌高 ,P <0 0 5 ;腹膜种植也明显比膨胀型癌高 ,P <0 0 1;5年生存率明显比膨胀型癌低 ,P <0 0 1。结论 :膨胀型癌易于血行转移 ;而浸润型癌容易淋巴结转移及腹膜种植 ;引起预后不良。胃癌 5年生存率由高至低依次为浸润至肌层及以内的浸润型癌 ,膨胀型癌 ;浸润至浆膜层及浆膜外的膨胀型癌 。

Objective To study the influence of metastasis pattern and prognosis of advanced gastric cancer by growth pattern in gastric wall.Methods According to Ming's classification,180 cases gastric cancer were separated into expanding cancer and infiltrative cancer.Metastasis patterns(hematogeneous metastasis,lymphatic metastasis,implantative metastasis)of different infiltrative depth expanding cancer and infiltrative cancer were analyzed,and 5-year survival rate and prognosis were compared.Results 1)Infiltrating muscul layer and non infiltrating muscul layer 47 cases:hematogeneous metastasis of expandingcancer was higher than that of infiltrative cancer,P<0.01.5-year survival rate of expanding cancer was lower than that of infiltrative cancer,P<0.05. 2)Infiltrating serosa and subserosa 133 cases:lymphatic metastasis rate of infiltrative cancer was higher than that of expanding cancer,P<0.05.Implantative metastasis of infiltrative cancer was higher than that of expanding cancer,P<0.01. 5-years survival rate of infiltrative cancer was higher than that of expanding cancer,P<0.01.Conclusions Hematogeneous is easy in expanding cancer and lymphatic metastasisand implantative cancer is easy ininfiltrative cancer leading to a bad prognosis.5-years survival rates of advanced gastric cancer from high to low are infiltrative cancer infilitrating muscul layer and non infiltraing muscul layer,expanding cancer of one; expanding cancer infiltrating serosa and subserosa,infiltrative cancer.