633例胃癌患者临床病理特征及生存分析

目的 对比不同Lauren分型胃癌的临床病理特征,对其进行生存分析,并筛选预后因子。方法 回顾性分析2007年1月1日—2008年6月30日在哈尔滨医科大学附属肿瘤医院接受手术治疗的胃癌患者的临床病理学资料,将收集到的633例胃癌患者分为肠型胃癌、弥漫型胃癌,对两组的临床病理特征及生存数据等进行统计分析。结果 对比弥漫型胃癌而言,肠型胃癌比例略高(51.66% vs. 48.34%),男性比例较高(2.94:1 vs. 2.03:1,P=0.035),更易发生于老年患者(发病年龄≥60岁比例54.43% vs. 35.94%,P＜0.001)。肠型胃癌预后明显好于弥漫性胃癌(中位生存时间:90.90个月 vs. 37.33个月,P=0.014)。多因素分析显示年龄≥60岁、CA199异常、肿瘤较大、分化较差、浆膜侵犯、初始淋巴结转移、姑息性手术、非幽门切除术是胃癌的不良预后因素。结论 Lauren分型可以较好的反应不同胃癌的临床病理学特征,并指导预后。

Clinicopatho logical features and survival analysis in 633 cases of gastric carcinoma

Objective The objectives of this study were to compare the clinicopathological features of different Lauren type gastric cancer,to carry out survival analysis,and to screen the prognostic factors.Methods The clinical pathologic data of gastric cancer patients who underwent surgical treatment at the Affiliated Tumor Hospital of Harbin Medical University from January 1,2007 to June 30,2007 were retrospectively analyzed.The 633 cases of gastric cancer patients were divided into intestinal type gastric cancer and diffuse type of gastric cancer groups,which were analyzed clinical and pathological characteristics and survival.Results Compared with diffuse type of gastric cancer,the proportion of intestinal type gastric cancer was slightly high(51.66% vs. 48.34%),the proportion of male was also high(2.94:1 vs.2.03:1,P=0.035).These could be more often in elderly patients age(≥60 years)(54.43% vs.35.94%,P<0.001).The prognosis of intestinal type gastric cancer was significantly better than diffuse gastric cancer(median survival time:90.9 months vs.37.33 months, P=0.014).Multivariate analysis showed that age ≥60 years old,CA199 abnormalities,larger tumors,poor differ-entiation,serosal invasion,initial lymph node metastasis,palliative surgery and non-pyloric resection were poor prognostic factors in gastric cancer.Conclusion Lauren type can be better respond to the clinicopathological fea-tures of different gastric cancer and guide to the prognosis.