早期胃癌复发的高危因素分析

目的 探讨早期胃癌根治性切除术后复发的高危因素.方法 以1994年1月至2008年1月间在大连医科大学附属第一医院普通外科行手术治疗的早期胃癌336例中的复发性早期胃癌12例为研究对象,未复发的324例为对照进行回顾性比较,分析其临床病理学资料及复发因素.结果 早期胃癌336例不同术式的5年生存率:D1为89.0％、D1+α 91.4％、D1+ 3 91.8％、D2为92.5％、D3为90.0％(P =0.981),其复发率为3.6％.复发时间17～ 58个月,生存时间为33～ 68个月.复发部位:血行转移6例,淋巴结复发4例,残胃复发2例.复发率:黏膜下层癌高于黏膜内癌(P =0.015),淋巴结转移阳性病例高于阴性病例(P =0.011),D1组高于D2组(P =0.025).结论 早期胃癌的复发率与肿瘤的浸润深度、淋巴结转移程度及淋巴结廓清的程度密切相关.

Clinicopathological analysis for postoperative recurrence in early gastric cancer patients

Objective To clarify the risk factors of postoperative recurrence of early gastric cancer (EGC)patients who underwent radical gastrectomy.Methods We investigated follow-up records of 336 EGC patients on whom curative operations were performed at the First Affiliated Hospital of Dalian Medical University between January 1994 and January 2008 with special reference to 12 cases of cancer recurrence.Results The 5-year survival rate of D1 was 89.0％,D1 + t was 91.4％,D1 + β was 91.8％,D2 was 92.5％,D3 was 90.0％(P =0.981).The recurrence rate was 3.6％(12/336).The recurrence time was 17-58 months,the survival time was 33-68 months.Six cases suffered from hematogenous recurrences,four cases from lymph node recurrences,two cases from remnant stomach recurrences.The recurrence rate of SM was higher than M(P =0.015),lymph node positive was high than negative(P =0.011),D1 was higher than D2(P =0.025).Conclusions The recurrence rate of EGC correlated with depth of invasion,lymph node metastasis and lymph node dissection.