胃癌术后残胃再发癌的危险因素分析

目的探讨残胃再发癌的危险因素，为其预防提供参考。方法胃癌切除术后残胃再发癌患者98例为残胃再发癌组，同期进行胃切除术但未出现残胃再发癌的胃癌患者100例为对照组。对两组患者的一般情况、原发癌的Borrmann分型、组织学类型、临床分期以及手术方式和残胃状态进行单因素和多因素回归分析。结果残胃再发癌组年龄大于60岁、吸烟者明显多于对照组（P〈0。01）；两组性别、饮酒、血型构成无显著差异。原发胃癌的Borrmann分型、组织学类型及临床分期在两组间有显著性差异（P〈0．01）。残胃再发癌中毕Ⅱ式根治术显著高于对照组。残胃再发癌组患有胆汁反流、Hp感染、低胃酸及残胃炎的比例均显著高于对照组。多因素分析发现患者年龄、Hp感染、低胃酸、临床分期和组织学类型这5个因素为残胃再发癌的独立危险因素。结论患者高龄、残胃伴发Hp感染、低胃酸状态及原发癌的临床分期和组织学类型是残胃再发癌的高危因素。认识残胃再发癌危险因素，对残胃再发癌的防治具有重要的指导意义。

Analysis on risk factors for recurrent gastric remnant cancer after resection of stomach for gastric cancer

Objective To explore the risk factors for recurrent gastric remnant cancer and to provide references for its prevention. Methods Ninety-eight patients with recurrent gastric remnant cancer were named as recurrent gastric remnant cancer group and 100 patients with stomach resection but no recurrent gastric remnant cancer were named as control group. The Borrmann type, histological type, clinical stage, condition of the gastric remnant as well as the general conditions of the two groups were analyzed by logistic regression. Results There were more patients with smoking habit and age over 60 in recurrent gastric remnant cancer group compared with those in control group （P 〈 0.01 ）, but there was no difference between the two groups in gender, drinking habits and blood type. There were obvious differences in Borrmann type, histological type and clinical stage between the two groups （ P 〈 0.01 ）. The patients with bile regurgitation, HP infection, hypochlorhydria and remnant gastritis were more in recurrent gastric remnant cancer group than in control group. The multiple factor regression analysis explored five risk factors （ age, HP infection, hypochlorhydria, histological type and clinical stage） for recurrent gastric remnant cancer. Conclusion Senior age, HP infection, hypochlorhydria, histological type and clinical stage are the risk factors for recurrent gastric remnant cancer. Recognizing these risk factors is helpful in the prevention of recurrent gastric remnant cancer.