影响胃癌肝转移患者预后的相关因素分析

目的 探讨影响胃癌肝转移患者生存的临床病理相关因素.方法 随访61例胃癌肝转移患者,选择可能影响胃癌肝转移患者预后的因素:年龄、性别、血型、病程、首发症状、肿瘤大体、肿瘤组织类型、病理分级、浸润层次、淋巴结转移、术前合并症、伴发病、手术性质、手术方式、肝转移病灶部位、肝转移灶数目、肝转移灶直径、肝转移发现时间、肝转移处理方式、术后化疗方案、HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc、CEA、CA-125、CA19-9、肝功能指标.单因素分析各因素对患者生存率的影响.多因素分析用COX比例风险模型.结果 胃癌肝转移患者的中位生存时间为11.0个月.单因素分析提示患者的年龄、病程、组织类型、肝转移病灶数目、肝转移发现时间、直接胆红素、谷氨酰转肽酶、谷丙转氨酶、术前抗-HBs是影响预后的主要因素.多因素分析提示年龄、病程、组织类型、肝转移病灶数目、直接胆红素、谷氨酰转肽酶、术前抗-HBs影响患者的预后.结论 患者年龄、病程、组织类型、肝转移病灶数目、直接胆红素、谷氨酰转肽酶、术前抗-HBs是影响胃癌肝转移患者预后的主要因素.

Analysis of Prognostic-related Factors in Gastric Carcinoma with Liver Metastasis

Objective To explore clinical pathologic factors related to survival of gastric carcinoma patients with liver metastasis.Methods Data of 61 cases of gastric carcinoma with liver metastasis were reviewed.The following factors were selected:age,gender,blood type,course of disease,symptom,gross appearance of tumor,tumor histotype,pathologic grade,infiltration,lymphatic metastasis,complications,nature of operation,operation method,the position,number and the maximum diameter of liver metastasis,detection time of liver metastasis,treatment of metastasis,chemotherapy after operation,HBsAg,anti-HBs,HBeAg,anti-HBe,anti-HBc,CEA,CA-125,CA19-9 and liver function.Univariate analysis with Kaplan-Meier methods and multivariate analysis with Cox regression model were used.Results The median survival time of gastric carcinoma with liver metastasis was 11.0 months.Univariate analysis showed ages,course of diseases,histotype,number and detection time of liver metastasis,direct bilirubin,glutamyl transpeptidase,glutamate pyruvate transaminase,HBsAg were the main prognostic factors.Multi-analysis showed ages,course of diseases,histotype,the number of liver metastasis,gamma glutamyl transpeptidase,direct bilirubin and HBsAg were the main prognostic factors.Conclusion Age,course of diseases,histotype,the number of liver metastasis,glutamyl transpeptidase,direct bilirubin and preoperative anti-HBs are the main prognosis-related factors.