影响进展期胃癌根治术后早期复发的相关因素分析

【目的】分析影响进展期胃癌根治术后早期复发的相关因素，为临床干预工作提供依据。【方法】选取2008年3月至2011年4月本院收治的195例进展期胃癌患者作为研究对象，所有患者均接受胃癌根治术治疗，根据患者术后1年内复发与否将上述患者分为早期复发组（n=103）与对照组（n=92）。先后采用χ2检验、非条件Logistic回归分析确定影响进展期胃癌根治术后早期复发的独立相关因素。【结果】①单因素分析发现，两组患者的肿瘤直径、Borrmann分型、Lauren分型、T分期、N分期、TNM分期、新辅助化疗、术后化疗等指标相比差异有统计学意义（P〈0．05），两组患者的性别、年龄、体质指数、肿瘤位置、分化程度、手术方式、腹腔镜手术等指标相比差异无统计学意义（P〉0．05）。②非条件Logistic回归发现，N分期、TNM分期是影响进展期胃癌根治术后早期复发的独立危险因素，而新辅助化疗是独立保护因素。【结论】进展期胃癌的N分期、TNM分期是其术后早期复发的独立危险因素，采取而新辅助化疗可降低进展期胃癌根治术后早期复发率。

Analysis on the Relevant Factors of Early Recurrence after Radical Resection for Patients withAdvanced Gastric Cancer

[Objective] To analyze the relevant factors of early recurrence after radical resection for ad- vanced gastric cancer so as to provide theoretical evidence for clinical intervention. [Methodsl Totally 195 pa- tients with advanced gastric cancer admitted into our hospital from March 2008 to April 2011 were selected as the objects of study. All patients underwent radical resection of gastric cancer. According to with or without recurrence one year after radical resection, these before-mentioned patients were divided into early recurrence group（ n =103） and control group（ n = 92）. Chi-square test and unconditioned logistic regression analysis were applied to determine the independent relevant factors for early recurrence after radical resection. IRe- suits] The univariate analysis found that there were significant differences in tumor diameter, Borrmann type, Lauren type, T stage, N stage, TNM stage, neoadjuvant chemotherapy and postoperative chemotherapy be- tween early recurrence group and control group（ P 〈0.05）, while there was no significant difference in gen- der, age, body mass index, tumor location, degree of differentiation, surgical approaches and laparoscopic surgery between two groups（ P 〉0.05）. The unconditioned logistic regression analysis found that N stage and TNM stage were independent risk factors for early recurrence after radical resection, but neoadjuvant chemo- therapy was an independent protective factor. [Conclusion] N stage and TNM stage are independent risk fac- tors of early recurrence after radical resection for advanced gastric cancer. Neoadjuvant chemotherapy can re- duce the early recurrence rate after radical resection for advanced gastric cancer.