T1a～T1b期胃癌患者发生脉管浸润的风险因素及预后分析

目的 分析影响T1a~T1b期胃癌患者发生脉管浸润的风险因素及预后生存情况,为胃癌患者的临床治疗提供参考。 方法 选取2013年3月-2015年6月在杭州师范大学附属医院诊断且符合纳入标准的80例T1a~T1b期胃癌患者为研究对象,按脉管是否浸润将其分为脉管浸润组(24例)和脉管未浸润组(56例)。比较2组患者的临床病理特征;采用Cox多因素分析影响T1a~T1b期胃癌患者发生脉管浸润的风险因素;比较2组患者的3年累积生存率。 结果 脉管浸润组患者淋巴结转移率明显高于脉管未浸润组(P<0.05)、肿瘤大体分型中溃疡型所占比例明显高于脉管未浸润组(P<0.05)、肿瘤分化程度中低分化所占比例明显高于脉管未浸润组(P<0.05)、肿瘤浸润深度中T1b期所占比例明显高于脉管未浸润组(P<0.05);2组患者的癌结节、肿瘤直径比较差异无统计学意义(P>0.05)。Cox多因素分析结果显示,淋巴结转移与肿瘤浸润深度是胃癌患者脉管浸润的独立风险因素(P<0.05)。脉管浸润组患者的3年累积生存率明显低于脉管未浸润组(P<0.05)。 结论 淋巴结转移、肿瘤浸润深度是T1a~T1b期胃癌患者发生脉管浸润的独立风险因素,发生脉管浸润的T1a~T1b期胃癌患者的预后情况不佳。 

Risk factors and prognosis of vascular invasion in patients with T1a-T1b gastric cancer

Objective To analyze the risk factors of vascular invasion in patients with stage T1 a-T1 b gastric cancer and their prognosis, and to provide reference for the clinical treatment of patients with gastric cancer. Methods A total of 80 patients with stage T1 a-T1 b gastric cancer faced the inclusion criteria in the Affiliated Hospital of Hangzhou Normal University from March 2013 to June 2015 were selected and divided into the vascular invasion group (24 cases) and the vascular non-invasion group (56 cases) according to whether the vessels were infiltrated. The clinicopathologic features were compared between the two groups. Cox multivariate analysis was used to analyze the risk factors of vascular invasion. The 3-year cumulative survival rate was compared between the two groups. Results When compared with the vascular non-invasion group, the patients in the vascular invasion group were with higher lymph node metastasis rate (P<0.05), lower proportion of ulcer type in gross classification of tumors (P<0.05), higher ratio of low differentiation (P<0.05), and higher proportion of T1 b stage in the depth of tumor invasion (P<0.05), the difference was statistical significant. There were no significant differences in the cancerous node and tumor diameter between the two groups (P>0.05). Cox multivariate analysis showed that lymph node metastasis and depth of tumor invasion were independent risk factors for vascular invasion in patients with gastric cancer (P<0.05). The 3 years cumulative survival rate of the vascular invasion group was significantly lower than that of the non-invasion group (P<0.05). Conclusion Lymph node metastasis and depth of tumor invasion are independent risk factors for vascular invasion in patients with T1 a-T1 b gastric cancer. The prognosis of stage T1 a-T1 b gastric cancer patients with vascular invasion is not good.