胃类癌生物学行为及与预后关系的临床研究

目的分析胃类癌特有的生物学行为与肿瘤预后之间的关系。方法总结1964年1月至2005年1月间收治的26例经手术切除、病理证实的胃类癌病例资料,对其肿瘤大小、胃壁侵犯深度、区域淋巴结转移、肝转移、术后辅助化疗和5年生存率进行分析。结果本组患者平均年龄58岁。其中18例(69.2%)肿瘤侵犯胃浆膜;12例(46.2%)有区域淋巴结转移;10例(38.5%)术后接受辅助化疗;14例(53.8%)在随访中出现肝转移。肿瘤大小与胃壁侵犯深度、区域淋巴结转移和肝转移的发生及5年生存率无关(P>0.05)。生存分析提示浆膜浸润、淋巴结转移和肝转移影响生存时间(P<0.05)。有浆膜浸润、淋巴结转移和肝转移的患者5年生存率分别为16.7%、16.7%和0,预后较差;化疗与否5年生存率比较,差异无统计学意义(P<0.05)。结论胃类癌术后辅助化疗并无益处,其预后与肿瘤的浸润深度、淋巴结转移和肝转移有关。

Relationship of biological behavior and the prognosis in gastric carcinoid

Objective To examine the relationship of biologic behavior and prognosis in patients with gastric carcinoid. Methods A total of 26 gastric carcinoid patients proven by pathology from Jan. 1964 to Jan. 2005 were enrolled. All the patients survived after operations. Tumor size,invasion depth,regional lymph node metastasis,liver metastasis,adjuvant chemotherapy and 5-year survival were analyzed retrospectively. A univariate analysis of survival rate with respect to gastric wall infiltration,regional lymph node metastasis,liver metastasis,and adjuvant chemotherapy were accomplished by Kaplan-Meier estimation method. The Log-rank test was used to evaluate the level of significance. Results The average age of 26 patients was 58 years. Infiltration beyond the serosa occurred in 18 patients (69.2%),and regional lymph node metastases in 12 patients (46.2%). During the follow-up period,liver metastases occurred in 14 patients (53.8%). Tumor size was not associated with gastric serosa invasion,regional lymph node metastasis,liver metastasis and 5-year survival (P>0.05). Analysis of cumulative survival showed different survival time depending on gastric serosa invasion,regional lymph node metastasis and liver metastasis. The difference was significant (P<0.05). In patients with gastric serosa invasion,regional lymph node metastasis and liver metastasis,estimated 5-year cumulative survivals were 16.7%,16.7% and 0 respectively. Their prognosis was poor. Adjuvant chemotherapy was administrated in 10 patients (38.5%) and was not beneficial to prolong the survival time and increase the 5-year survival rate. The difference was not statistically significant (P>0.05). Conclusions Surgical resection is the major strategy for the treatment of gastric carcinoid,and adjuvant chemotherapy is not proved to produce obvious effects. The prognosis of gastric carcinoid depends on the tumor infiltration of gastric wall,regional metastasis and liver metastasis.