进展期胃癌预后多因素分析

目的：对影响进展期胃癌患者预后的多种因素进行分析，以提高对进展期胃癌的认识和治疗水平。方法：对我院1998年1月-2002年12月间411例进展期胃癌术后患者进行了随访，对其一般资料、手术情况、病理结果及生存期等数据进行统计分析。结果：411例病例中失访48例，随访363例中目前仍存活174例，死亡189例，总体1、3、5年累积生存率分别为79．89％、56．20％、50．76％。单因素分析：与进展期胃癌预后有关的因素包括年龄、肿瘤部位、肿瘤大小、组织类型、浸润深度、分期、清扫淋巴结总数、淋巴结转移个数、淋巴管癌栓、切缘残留、淋巴结转移率、远处转移。多因素分析：与进展期胃癌预后相关的独立因素包括肿瘤分期、组织类型、转移淋巴结个数、淋巴结转移率、肿瘤大小。结论：经COX模型分析，肿瘤分期、组织类型、转移淋巴结个数、淋巴结转移率、肿瘤大小是影响胃癌预后的独立因素，其中肿瘤分期是影响胃癌预后最重要的因素。

Multivariate prognostic analysis in advanced gastric cancer

Objective：To analyse the multivariate prognostic factors of the AGC. Methods： A total of 411 patients with advanced gastric adenocarcinoma resection were enrolled in this trial. The data concerning common state of patients, surgical treatment and pathological factors were collected and analysed. Results： Among 411 patients 363 patients was followed up,with 48 cases censored and 189 cases died, 17,1 still alive, the overall survival rate for 1, 3,5 years were 79.89% ,56.20% ,50.76% respectively. The results of univariate analysis indicated that age, tumor site, tumor diameter, histological subtypes, depth of invasion, pTNM stage, total lymphnodes, metastasis lymphnodes, lympgatic vessel involvement,positive margins, metastasis lymphnodes ratio and distant metastasis were found to be significantly associated with the cumulative survival rate. Among the variables selected by the univariate analysis, only five （pTNM stage, histological subtypes, metastasis lymphnodes, metastasis lymphnodes ratio and tumor diameter）were recognized as significant prognostic factors. Conclusion： pTNM stage, histological subtype, lymphnodes metastasis, ratio of lymphnodes metastasis and tumor diameter have been recognized as significant prognostic factors, in which pTNM stage is more important than the other four factor.