贲门癌最大径分级与预后的关系探讨

目的　探讨贲门癌最大径与预后的关系 ,寻找更符合贲门癌预后的分期方法。方法采用Stata 5 0统计软件 ,对 195 8年 6月～ 1993年 10月底 ,经左胸后外切口为主途径行贲门癌切除的15 36例病例建立病例资料数据库并进行统计分析。生存率用寿命表法计算 ,两组间生存率差异的显著性用Log rank检验 ,两组间率的差异的显著性用 χ2 检验。结果　本组将肿瘤最大径分为 6个级别 :Ⅰ级 :<2cm ;Ⅱ级 :2～ <4cm ;Ⅲ级 :4～ <6cm ;Ⅳ级 :6～ <8cm ;Ⅴ级 :8～ <11cm ;Ⅵ级 :≥ 11cm。各级的 5年生存率分别为 :Ⅰ级 6 1 5 % ;Ⅱ级 44 4% ;Ⅲ级 2 6 4% ;Ⅳ级 2 0 5 % ;Ⅴ级 16 1%及Ⅵ级5 7%。除Ⅰ级与Ⅱ级之间的差异无显著性外 ,其他各级之间差异均有显著性 (P <0 0 5 )。各级与淋巴结转移呈极显著的正相关关系。结论　按肿瘤最大径分级可分为 6级 ,各级对预后影响的差异均有显著性。

Correlation study of the longest diameter of gastric cardia cancer and its prognosis

OBJECTIVE: Based on the longest diameter of cancer of gastric cardia, to formulate a new way of staging for better assessment of prognosis. METHODS: A total of 1,536 cases of resected carcinoma of the gastric cardia through left thoracic approach was statistically analyzed using STATA 5.0 software. The survival rate was estimated using life table method. The difference in survival rate between groups was evaluated by the log-rank test. The ratio difference between groups was evaluated by chi 2 test. RESULTS: The longest tumor diameter was divided into 6 grades according to its length: grade I, < 2 cm; grade II, 2 cm-< 4 cm; grade III, 4 cm-< 6 cm; grade IV, 6 cm-< 8 cm; grade V, 8 cm-< 11 cm and grade VI, > or = 11 cm. The 5-year survival rate was 61.5% in grade I, 44.4% in grade II, 26.4% in grade III, 20.5% in grade IV, 16.1% in grade V and 5.7% in grade VI, respectively. There was statistically significant difference (P < 0.05) in 5-year survival rate between 2 grades from grade II to grade VI. CONCLUSION: The longest tumor diameter is of prognostic significance in cancer of gastric cardia.