胃腺癌根治术后复发影响因素分析

目的 探讨胃腺癌根治术后早期复发和晚期复发的影响因素.方法 回顾性分析214例胃腺癌根治术后复发患者临床资料,其中＜2年复发143例,≥2年复发71例,分析患者年龄、性别、肿瘤的部位、肿瘤的直径、肿瘤病理学分级、Borrmann分型、TNM分期、淋巴结转移、手术性质及术后有无辅助化疗等指标与胃腺癌复发的关系.结果 单因素分析显示,肿瘤直径、Borrmann分型、TNM分期、淋巴结转移、手术性质和辅助化疗与术后复发时间有关(检验值分别为8.32、16.21、24.90、5.22、17.23和3.61,均P＜0.05)；多因素分析显示,肿瘤直径和TNM分期是术后复发的独立因素(相对危险度分别为5.642和6.211,均P＜0.05).结论 肿瘤直径和TNM分期是影响胃腺癌根治术后复发的最重要的影响因素.

Analysis of the risk factors of recurrence after curative resection for gastric adenocarcinoma

Objective To explore prognostic factors associated with early and late recurrences after surgery for patients with gastric adenocarcinoma. Methods 214 patients who underwent curative resection for gastric adeno-carcinoma were divided into 2 groups according to recurrence time ： an early recurrence group included 143 patients who died within 2 years after surgery, and a late recurrence group included 71 patients who died more than 2 years after surgery. Indexes such as age, sex,tumor site,tumor size,tumor pathology classification, Borrmann type,TNM staging, lymph node metastasis, operation type and postoperative adjuvant chemotherapy were compared. Results Single factor analysis showed that the tumor diameter, Borrmann type, TNM staging, lymph node metastasis, operation type, adjuvant chemotherapy were asocciated with postoperative recurrence （ test value were 8.32,16.21,24.90,5.22, 17.23 and 3.61, respectively ; all P 〈 0.05 ）. Muhifaetor analysis showed that tumor diameter and TNM staging is recurrent independent factors （ relative risk were 5. 642 and 6.211, respectively ; all P 〈 0.05 ）. Conclusion Tumor size and TNM staging are the most important factors for predicting the timing of recurrence after curative resection for gastric adenocarcinoma. Clinical practice should pay attention to follow up for patients with tumor diameter≥5cm,TNM III-IV stage, especially within two years.