侵犯膈肌T4期贲门癌的预后分析

目的分析侵犯膈肌T4期贲门癌患者的预后情况。方法回顾性分析654例贲门腺癌患者的临床病理资料。按照胃癌分期系统进行分期，选取Ⅳ期（T4N1～2M0，T1～4N3M0，任何T任何NM1）贲门癌患者，分析并对比T4N1～2M0贲门癌患者与其余Ⅳ期贲门癌患者的生存情况，分析并对比T4N1～2M0贵门癌患者中侵犯膈肌患者与非侵犯膈肌患者的生存情况．结果Ⅳ期贲门癌患者197例，其中T4N1～2M0患者34例（17．3％）。T4N1～2M0患者与其余Ⅳ期患者生存率存在显著性差异（P=0．010），3年生存率分别为25．0％、7．9％。T4N1-2M0患者中仅侵犯膈肌患者与非侵犯膈肌患者生存率存在显著性差异（P=0．001），3年生存率分别为46．2％，10．5％。T4N1～2M0患者中非侵犯膈肌患者与Ⅳ期患者生存率不存在显著性差异（P=0．723）。结论T4N1-2M0贲门癌患者预后优于其余Ⅳ期贲门癌患者，其中以仅侵犯膈肌患者的预后较佳．

Analysis of the Prognosis of the Patients with Cardia Adenocarcinoma of Stage T_4 with Diapharam Invasion

Objective To analysze the prognosis of the patients with cardia carcinoma of stage T4. Methods Retrospectively analyzed the clinical and pathological records of 654 patients with cardia adenocarcinoma. Selected the patinets in the stage Ⅳ（T4N1-2M0 ,T1-4 N3M0 ,any T any N M1 ）. Analyzed and compared the survival rate of the patients with T4N1-2M0 disease with that of the other patients. Analyzed and compared the survival rates of the patients with and without diapharagm invasion with T4N1 -2M0. Results There were 197 patients in the stage Ⅳ,and 34 patients with T4N1-2M0 disease （ 17.3% ）. There was significant difference between the survival rates of patients with T4N1 -2M0 disease and that of the other patients （P =0. 010） ,and the 3-year survival rates were 25.0% and 7.9%. In the patients with T4N1-2 M0 disease, there was significant difference between the survival rates of patients with diapharagm invasion only and that of the patients without diapharagm invasion only （ P = 0.001 ） ,and the 3-year survival rates were 46.2% and 10.5%. There was no significant difference between the survival rates of patients with T4N1 -2 M0 disease without diapharagm invasion only and that of the other patients of stage Ⅳ（P = 0.723 ）. Conclusion The prognosis of the patients with cardia adenocarcinoma with T4N1-2M0 disease was better than that of the other patients of stage Ⅳ ,especially the patients with diaphagram invasion only.