局限型与浸润型胃癌临床病理特点及预后对比分析

目的:探讨局限型胃癌与浸润型胃癌的临床病理特点及预后。方法:对1980年1 月至2000年1 月20年间中国医科大学附属第一医院肿瘤外科收治的进展期胃癌患者的临床病理资料与生存情况按大体分型的不同进行对比分析。结果:两型胃癌患者在性别、病灶位置、组织分型、浸润深度、淋巴结转移、淋巴管癌拴发生率、生长方式、手术根治程度等方面差异有统计学意义，而在发病年龄和病灶大小静脉癌拴发生率方面差异无统计学意义。浸润型胃癌预后差，当肿瘤局限于肌层及浆膜下层时，两组胃癌预后差异有统计学意义，一旦肿瘤浸润超过浆膜层两型胃癌预后差异无统计学意义。局限型胃癌预后的与病灶位置和淋巴结转移程度密切相关；而影响浸润型胃癌预后的因素是淋巴结转移情况、肿瘤浸润深度及病灶大小。结论:局限型胃癌与浸润型胃癌临床病理特点及预后有显著性差异，根据其生物学行为特点采取恰当治疗措施，将有助于提高治疗效果。 

Comparative Analysis between Clinicopathologic Characteristics and Prognosis in Patients with Local and Infiltrative Gastric Cancer

Objective: To investigate the differences between the clinicopathologic characteristics and prognostic fac -tors in patients with localized and infiltrative gastric cancer (GC). Methods:Patients with advanced GC, who were admitted to the Department of Surgical Oncology of the First Affiliated Hospital of China Medical University, Shenyang, during the pe -riod January 1980 to January 2000, were divided into localized and infiltrative GC groups. A comparative analysis of the clinicopathologic data and prognosis in the patients enrolled in the study was carried out based on the different macroscop-ic types. Results: There were significant differences in the sex ratio, tumor location, histologic type, depth of invasion, lymph node metastasis, lymphovascular cancer embolus (LVCE), growth pattern, and degree of radical surgery between the 2 groups. However, there were no significant differences in age, tumor size, and intravenous cancer embolus between the 2 groups. The prognosis of the infiltrative GC group was poor. There were significant differences in the prognosis of the patients between the 2 groups when tumor infiltration was within the muscular layer or subserosa, yet the differences disap -peared once the tumor infiltration was beyond the serosal layer. The prognosis of the patients with localized GC was close-ly related to tumor location and lymph node metastasis. The prognostic factors of the patients in the infiltrative GC group in -cluded lymph node metastasis, depth of invasion, and tumor size. Conclusion:There are significant differences in the clini-copathologic characteristics and prognosis between the 2 groups. Based on the biological characteristics of the tumors, in dividualized therapeutic plans for patients will help to improve treatment outcomes.