胃癌根治术257例预后多因素分析

目的 分析影响胃癌患者预后的因素.方法 回顾性分析我院2003年1月至2008年10月收治的行胃癌根治术的257例患者的临床资料,采用Kaplan-Meier生存率分析法和Log-rank检验进行单因素分析,Cox比例风险模型进行多因素分析.结果 单因素分析表明:肿瘤部位、Borrmann分型、组织学类型、肿瘤浸润深度、淋巴结转移度、肿瘤大小,并发症、化疗是影响胃癌预后的相关因素(P<0.05或P<0.01);经Cox模型分析得出4个影响胃癌根治术患者预后的独立因素,按照其价值从大到小排列:淋巴结转移度,肿瘤浸润深度,Borrmann分型,肿瘤大小(P均<0.05).根据相对危险度Exp(B)可得出结论淋巴结转移度、肿瘤浸润深度、Borrmann分型、肿瘤大小每增加一个等级,胃癌根治术患者死亡的相对危险度分别增高3.374倍,2.337倍,1.657倍,1.580倍.结论 影响胃癌预后的因素较多,其中淋巴结转移度对胃癌预后影响最大.

Prognostic indicators in gastric cancer patients underwent radical resectioa

Objective To analyze the prognostic indicators in gastric cancer patients underwent radical resection.Methods Clinical data of 257 patients with gastric cancer underwent radical resection from Jan. 2003 to Oct. 2008 in our hospital were analyzed retrospectively. Univariate analysis using Kaplan-Meier analysis and log-rank analysis,multivariate analysis using COX proportion risk model were performed. Results Univariate analysis indicated that tumor site (P <0. 05) .Borrmann type (P <0. 01) .histological type (P <0. 01),depth of infiltration (P < 0. 01 ) , lymph node metastasis rate ( P < 0. 01 ) , tumor size ( P < 0. 01 ) ,complication ( P < 0. 01 ) and accessorial chemotherapy (P<0. 01) influenced the patients' prognosis. Cox regression analysis indicated that lymph node metastasis rate, depth of infiltration, Borrmann type and tumor size were the independent risk factors of prognosis(P<0. 05). The relative risk will increase 3.374 times,2. 337 times,1.657 times and 1.580 times with each additional level of lymph node metastasis, depth of infiltration, Borrmann type and tumor size. Conclusions There are various factors influencing the prognosis of gastric cancer,of which lymph node metastasis rate is the most important prognosis indicator.