胃癌胰体尾侵犯的发病因素和临床结局分析

目的探讨胃癌病人胰体尾侵犯的相关临床病理因素和手术干预的临床结局。方法回顾性分析1994年8月至2006年3月间中山大学附属第一医院胃癌数据库资料中病人的临床病理资料和随访结果。结果870例胃癌病人中有73例发生胰体尾侵犯。BorrmannⅣ型、肿瘤穿透浆膜、离胃〉3cm淋巴结转移、腹膜扩散与胃癌胰体尾侵犯相关（P〈0．05）。联合胰体尾切除根治术后，较严重的并发症发生率为2．3％（1／44），围手术期内无病人死亡。联合胰体尾切除根治术组病人1、3、5年存活率分别为63％、24％和19％，其1年内各时点存活率总体上高于胃癌姑息性切除组和姑息性手术组（P〈0．05）。结论联合胰体尾切除的根治术具有可接受的手术并发症发生率，能显著改善胃癌胰体尾侵犯病人的近期预后。

Analysis of the clinicopathologic factors and clinic outcomes for gastric cancer patients with pancreatic body/tail invasion

Objective To investigate the clinicopathologic factors of gastric cancer with pancreatic body/tail invasion and the clinic outcomes of pancreatic body/tail resection for these patients.Methods Based on our database built from August 1994 to March 2006,the clinicopathologic data and the outcomes of the follow-up were analyzed respectively using the software of SPSS.Results Among the 870 gastric cancer patients,73 patients had pancreatic body/tail invasion.The clinicopathologic factors correlated with pancreatic body/tail invasion included primary tumor penetrating through the serosa,Borrmann IV,peritoneal dissemination and N2 lymph node metastasis (P<0.05).Major postoperative complication rate was 2.3% (1/44),and the mortality was 0.The 1-,3-,and 5-year survival rate of the patients undergoing the radical operation combined with pancreatic body/tail excision (RO group) was 63%,24% and 19%,respectively.The overall survival rates of RO group within 1 year after the operation were higher than those undergoing palliative resection (PR group) and those undergoing palliative operation (PO group),respectively (P<0.05).Conclusion The radical operation combined with pancreatic body/tail resection has an acceptable morbidity,and could improve the short-term survival rate of the patients with pancreatic body/tail invasion.