胃癌胃全切患者预后的影响因素

目的探讨接受胃全切治疗的胃癌患者预后的影响因素。方法回顾性分析接受胃全切手术治疗的胃癌患者的临床资料。观察患者1年死亡率,采用单因素分析法比较不同临床病理特征的胃癌患者死亡率的差异,采用Logistic回归分析法分析影响患者生存情况的因素。结果参与本项研究的210例患者中,1年内死亡28例,死亡率为13.3%;年龄≥65岁,肿瘤部位位于上部,直径≥4 cm,临床分期为Ⅲ~Ⅳ期,分化程度为中、低分化,癌胚抗原(CEA)、糖链抗原125(CA125)和高糖链抗原19-9(CA19-9)水平较高的患者死亡率较高,差异具有统计学意义(P0.05,P0.01);而不同性别的患者死亡率差异不显著;将单因素分析有意义的年龄、肿瘤部位、肿瘤直径、临床分期、分化程度、CEA、CA125和CA19-9水平为自变量,以患者是否死亡为因变量进行Logistic回归分析,结果表明,患者的临床分期、分化程度和CA19-9水平进入回归方程,OR分别为4.356、5.238和3.562,(P0.05,P0.01)。结论临床分期、分化程度和CA19-9水平是影响胃癌胃全切患者生存率的独立危险因素。

Prognostic factors of Gastric Cancer Patients with Total Gastric Resection

Objective To investigate the prognostic factors of gastric cancer patients with total gastric resection.Methods The clinical data of patients with gastric cancer who underwent total gastric resection in our hospital between August 2010 and September 2014 were retrospectively analyzed.The one-year survival rate of patients was observed.The survival rates of patients with gastric cancer were compared by single factor analysis.The factors that significantly influenced the survival rate of patients with gastric cancer were analyzed by Logistic regression analysis.Results Among the 210 patients who participated in the study,28 died within a year,and the death rate was 13.33％.A mortality rate was associated with age above 65 years,location of cancer in the upper part of the stomach,a diameter ≥ 4 cm,clinical stage Ⅲ to ⅣV,middle-and low-differentiation,higher CEA,higher CA125 and higher CA19-9 levels.The difference was statistically significant(P＜0.05),and the mortality rate was not significantly different between the two genders.Such statistically significant single factors as age,tumor location,diameter of tumor,clinical stage,degree of differentiation,CEA,CA125 and CA19-9 levels were usedas independent variables,while death was used as a dependent variable,which were analyzed by Logistic regression analysis.Results The clinical stage,degree of differentiation and serum CA19-9 level were included into the regression equation as risk factors(OR=4.356,5.238 and 3.562,P＜0.05).Conclusion Age,tumor location and diameter,clinical stage,tumor differentiation and sign levels could influence the survival rate of gastric resection patients while clinical stage,degree of differentiation and serum CA19-9 level are independent risk factors that affect the survival rate of patients.