影响无淋巴结转移胃癌病人预后的因素

目的探讨无淋巴结转移胃癌病人影响术后长期生存的因素。方法对98例接受根治性切除的无淋巴结转移胃癌病人进行单因素和多因素分析,与同期111例有淋巴结转移胃癌病人对比。结果无淋巴结转移组肿瘤体积较小、早期病人较多、分化较好、肿瘤局限于黏膜和肌层者较多。5年存活率64%高于淋巴结转移组的54%(P<0.05)。多因素分析表明,性别、反酸史、肿瘤大小、分期、分化程度低和穿透深度是影响预后的独立因素。结论无淋巴结转移胃癌病人的预后较好,影响长期生存的因素是女性、反酸史、肿瘤体积>3cm、进展期、分化程度低和侵犯浆膜。扩大淋巴结清扫范围并不改善预后。

Factors Affecting Prognosis in Patients with Node-negative Gastric Cancer

Objective To explore the factors influencing the prognosis in the patiens with node-negative gastric cancer. Methods Clinicopathologic data of 98 gastric cancer patients without lymph node metastasis were compared with those with lymph node metastasis. Prognostic facors were investigated by statistic analyses. Results Compared with node-positive group, node-negative group was characerized by smaller tumor size, more early patients, better differentiation, and more limited depth of tumor invasion. Five-year survival rates were 64% in the patients with node-negative tumor and down to 54% in node-positive group. (P<0.05). Multivariable analysis demonstrated that female, acid regurgitation, tumor size larger than 3 cm, poor differentiation and invasion into serosa were independent prognostic factors. Conclusion Node-negative gastric cancer is associated with a favorable outcome. Female, acid regurtation, tumor size larger than 3 cm, poor differentiation and invasion into serosa were independent prgnistic factors.