胃癌异时性肝转移危险因素分析

目的探讨影响胃癌根治术后异时性肝转移发生的危险因素。方法回顾性分析天津医科大学肿瘤医院1996--2008年间收治的115例胃癌异时性肝转移患者的临床病理资料，分别采用Log—rank检验和Cox模型对影响胃癌异时性肝转移发生的临床病理因素进行单因素和多因素分析。结果胃癌根治术后1、3和5年无肝转移率分别为45.3％、14．8％和3．5％。单因素分析显示，原发瘤部位、大小、分化程度、浸润深度、淋巴结转移、血管浸润、神经浸润、软组织浸润及切除方式与胃癌根治术后肝转移的发生有关（均P〈0．05）。多因素分析显示，原发瘤大小、血管浸润、分化程度和淋巴结转移是影响胃癌异时性肝转移发生的独立因素（均P〈0．05）。结论原发灶大小、血管浸润、分化程度和淋巴结转移是预估胃癌异时性肝转移发生的重要因素。

Risk factors in metachronous liver metastasis from gastric cancer

Objective To explore the clinicopathological characteristics and related risk factors in metachronous liver metastasis of gastric cancer. Methods Clinical data of 115 patients with metachronous liver metastasis in Tianjin Medical University Cancer Institute and Hospital between 1996 and 2008 were analyzed retrospectively . Results Among 115 patients, the 1-, 3- and 5-year non- hepatic metastasis rates were 45.3%, 14.8% and 3.5% respectively. Univariate Log-rank test indicated that location, tumor size, tumor differentiation, depth of invasion, lymph node metastasis, vascular invasion, nervous invasion, soft tissue invasion, and modes of gastrectomy were significant factors associated with hepatic metastasis after radical gastrectomy. On multivariate analysis, the size of gastric cancer, vascular invasion, tumor differentiation, and lymph node metastasis were independent factors associated with metachronous liver metastasis of gastric cancer. Conclusions The size of gastric cancer, vascular invasion, tumor differentiation and lymph node metastasis are important factors associated with the risk of hepatic metastasis from gastric cancer in patients after radical gastrectomy.