胃癌肝转移预后影响因素及不同治疗方法的临床研究

目的探讨胃癌肝转移预后的影响因素并对不同的治疗方法的临床效果进行研究。方法回顾性分析2001年5月～2013年5月在我院确诊的胃癌肝转移患者316例的临床资料，以采用的不同的治疗方法对研究对象进行分组，其中手术组173例，采用胃切除辅以化疗进行治疗，化疗组143例，采用单纯化疗方式进行治疗；对相同期间我院进行胃癌切除术患者中的165例同时性胃癌肝转移患者的临床资料进行回顾性分析。采用统计学方法对研究结果进行处理。结果①同时性胃癌肝转移患者生存期的独立预后因素包括以下几个方面：肝外转移、胃切除术及TACE，差异具有显著性（P〈0．05）。②采用胃原发病灶切除术治疗同时性胃癌肝转移患者后的影响因素中淋巴结清扫范围、H、N及脉管癌栓为其预后因素，差异具有显著性（P〈0．05）。③胃癌原发灶切除及肝转移灶手术治疗患者的影响因素中淋巴结清扫范围、H及N为其独立预后因子，差异具有显著性（P〈0．05）。结论临床应该提高胃癌肝转移预后影响因素的重视程度，以达到提高胃癌肝转移患者的临床治疗效果的目的。

Clinical study on the factors influencing the prognosis of hepatic metasta- sis in gastric carcinoma and different treatment methods

Objective To explore the influence factors of prognosis of gastric cancer with liver metastasis and clinical effects of different treatment. Methods We Retrospective analyzed the clinical data of 316 patients from 2001 May to 2013 May in our hospital diagnosed with liver metastasis of gastric cancer,We grouped them by different treatment methods, operation group were 173 cases,gastric resection combined with chemotherapy, chemotherapy group were 143 cases,using a simple chemotherapy treatment modalities for treatment; the same period in our hospital for gastric cancer clinical data of 165 patients with simultaneous hepatic metastasis of gastric cancer surgery patients were retro- spectively analyzed. We used statistical method to process the results. Results （1）Liver metastasis of gastric cancer were independent prognostic factors for survival as followings ： Extrahepatic metastasis （HI, H, H2, H3）, and TACE, the difference was significant （P 〈 0.05 ）. （2） Gastric primary tumor resection in the treatment of liver metastasis of gastric cancer and the influencing factors of patients in the lymph node dissection, H, N and vascular tumor thrombus for the prognostic factors,the difference was significant （P 〈 0.05）. （3） In primary gastric cancer lymph node dissection, H and N as the independent prognostic factors influencing factors of treatment of patients with metastatic loci operation resection and liver, the difference was significant （P 〈 0.05）. Conclusion In Clinical the factors influencing progno- sis of gastric cancer with liver should be improved in order to improve the clinical treatment effect in patients with hepatic metastasis of gastric cancer objective.