新疆306例老年胃癌患者临床病理特征及预后分析

目的：探讨老年胃癌的临床病理特点及影响预后的相关因素。方法：回顾性分析306例老年胃癌患者临床病理资料，采用Kaplan-meier法计算患者的生存率，Log-rank检验进行单因素分析，Cox多因素回归分析与胃癌相关指标的预后意义。结果：随访的306胃癌患者中，存活123例，死亡183例，1、3、5年总体生存率分别为78.9％、43.2％、28.6％；单因素分析显示年龄、性别、民族、合并症、组织学分级、浸润深度、脉管及神经受侵、淋巴结转移、远处转移、肿瘤标志物与胃癌的预后相关（ P＜0.05）；吸烟史、肿瘤家族史、幽门螺杆菌（Hp）感染史、肿瘤部位、甲胎蛋白（AFP）与胃癌的预后无显著影响（P＞0.05）。Cox多因素分析结果显示年龄、合并症、饮酒史、脉管侵犯、浸润深度、淋巴结转移、pTNM分期、根治性手术是影响胃癌预后的独立危险因素。结论：年龄、合并症、饮酒史、脉管侵犯、浸润深度、淋巴结转移、pTNM分期、根治性手术是影响老年胃癌预后的独立危险因素；而pTNM分期反映肿瘤的生物学特性和进展状况，临床应用价值较高。

Clinicopathological characteristics and prognosis of 306 aged gastric cancer patients in Xinjiang

Objective：To explore the clinicopathological characteristics and the factors influencing the prognosis of gastric cancer in aged patients. Methods：Collected data of 306 patients with gastric cancer,confirmed by the histopa-thology in the First Affiliated Hospital of Xinjiang Medical University. Kaplan-meier and Cox regression were used to e-valuate the overall survival rate of patients and the prognostic significance of factors related to gastric cancer . Results：Of 306 cases followed up,123 still alive and 183 died,the overall survival rates for 1,3 and 5 years were 78. 9%,43. 2%, 28. 6%. The result of univariate analysis showed that age,complications,depth of invasion,histological grade,vascular and nerve,lymph node metastasis,distant metastasis,pTNM stage and radical surgery were related to prognosis of gas-tric cancer,while gender,tumor site nation,family history of cancer,Hp infection had no relationship. The Cox multi-variate analysis showed that age,complications,radical surgery,depth of invasion,lymph node metastasis and pTNM stage were independent prognostic factors. Conclusion：Many factors affect the prognosis of gastric cancer,in which age,complications,radical surgery,depth of invasion,lymph node metastasis and pTNM stage were independent prog-nostic factors. The pTNM stage have a high clinical value,which reflects the biological characteristics and the progress of the tumor.