肿瘤家族史与胃癌患者临床病理特征关系的研究

目的:探讨恶性肿瘤家族史（familial history of malignant neoplasm,MN-FH）对胃癌贡献比例及与临床病理特征之间的关系。方法:回顾我院2010年1月-2014年12月间收治的资料齐全的310例胃癌患者的临床病理资料，以有无肿瘤家族史分组，利用SPSS软件统计分析组间临床病理特征关系。结果:96例（31.0%）胃癌患者具有肿瘤家族史，其一级和二级亲属中共有64例（66.7%）具有消化道相关肿瘤，包括食管癌（19.8%）、胃癌（24.0%）、肝癌（6.3%）和结直肠癌（16.7%）。泌尿系肿瘤占12.5%，其他（包括甲状腺癌、乳腺癌、喉癌等）占20.8%。相关性分析显示有无肿瘤家族史在性别及肿瘤发生部位均没有差异（P＞0.05）。病理分型显示有MN-FH的胃癌患者以低分化、未分化多见，占60.4%(58/96)，无MN-FH占12.6%(27/214)，两组相比，P＜0.05。而在高、中分化腺癌类型上则相反，有MN-FH胃癌组占39.6%，无MN-FH胃癌组占87.3%，P＜0.05。胃癌临床分期显示有MN-FH多以Ⅲ、Ⅳ期为主（73.0%），无MN-FH组以Ⅱ期为主（57.9%），两组相比，P＜0.05，具有显著性差异。结论:我院超过1/3的胃癌患者具有阳性MN-FH。其中最常见的MN-FH是消化道肿瘤。MN-FH胃癌具有分化程度低，病理特征恶性程度高特点。对于有家族史人群定期体检非常重要，早诊和早治是提高生存率的关键。

Family history of cancer associated with gastric cancer clinicopathological features

Objective:To investigate the clinicopathological characteristics and familial history of malignant neoplasm (MN-FH) of gastric cancer patients.Methods:The clinical data of 310 cancer cases in our hospital during January 2010 to December 2014 were analyzed retrospectively.Results:96 cases (31.0%) patients of gastric cancer had family history of cancer.Of the primary and secondary relatives,64 cases (66.7%) had digestive tract tumors,including esophageal cancer (19.8%),gastric cancer (24.0%),liver (6.3%) and colorectal cancer (16.7%).Urinary system tumor accounted for 12.5%,other (including thyroid cancer,breast cancer,laryngeal cancer,etc.) accounted for 20.8%.The correlation analysis showed that there was no difference between MN-FH and sex,the location of tumor (P＞0.05).The pathological typing showed that gastric cancer patients with MN-FH were mainly low differentiation and not differentiation,accounting for 60.4%(58/96),no MN-FH accounted for 12.6%(27/214),compared with the two group,P＜0.05.While in the high and medium differentiated adenocarcinoma types,there was 39.6% in MN-FH gastric cancer patients,was 7.3% in no MN-FH gastric cancer group,P＜0.05.The clinical staging of gastric cancer showed that gastric cancer patients with MN-FH were mainly IV stage (73.0%),and no MN-FH group (57.9%),P＜0.05.Conclusion:Over 1/3 in our hospital patients of gastric cancer had a positive MN-FH.The most common forms is gastrointestinal cancer.MN-FH gastric cancer has the features of low differentiation degree and high pathological features of malignant degree.It is important to early diagnoze and treat patients of gastric cancer with positive MN-FH.