109例早期胃癌的预后分析

目的探讨早期胃癌预后的影响因素。方法回顾性分析2004年7月至2007年7月实施D2根治术且资料完整的109例早期胃癌患者临床资料,采用Kaplan-Meier法进行生存分析,应用Logrank检验进行单因素分析;Cox比例风险模型进行多因素分析。结果早期胃癌患者术后1、3、5年生存率分别为97.2%,96.3%和93.6%。单因素分析结果显示术后患者预后与肿瘤部位、肿瘤直径、组织学类型、分化程度、浸润深度及淋巴结转移有关,其中组织学类型(RR=19.171,95%CI:5.767~63.736,P=0.000)和淋巴结转移(RR=13.988,95%CI:2.618~74.753,P=0.002)是早期胃癌术后患者预后的独立影响因素。结论早期印戒细胞胃癌伴(或)有区域淋巴结转移的患者预后差,应行D2手术,并应接受综合治疗及严格随访。

Long-term survival results and prognostic factors of 109 early gastric cancer

Objective To clarify the prognostic factors of early gastric cancer. Methods 109 patients who got D2 surgery in the affiliated hospital of Qingdao university from July 2004 to July 2007 were retrospectively evaluated. The relationship between survival time and clinico-pathological factors were evaluated by univariable and multivariable Logistic regression analyses. Results The overall survival rates of 109 patients were 97. 2%,96. 3% and 93. 6% at 1,3 and 5 years,respectively. Histological type,location,diameter,type,lymph node status,and depth of infiltration were significant prognostic factors in univariable analyses. The multivariate analysis identified histological type and lymph node status as the independent prognostic factors in our series. Conclusions Lymph node metastasis and（ or） signet ring cell carcinoma are the most important prognostic factors in early gastric cancer. Patients should receive D2 operation and comprehensive therapy and strict follow up.