早期胃癌的临床病理特征及预后分析

目的分析早期胃癌的临床病理特征与预后之间的关系。方法回顾性分析1994年1月至2005年10月间,在我院实施D2根治术且资料完整的255例早期胃癌患者的临床资料,采用Kaplan-Meier法进行生存分析,Logrank检验进行统计学比较,Cox比例风险模型进行多因素分析。结果 255例患者的5年生存率为91.4%。单因素分析显示,肿瘤浸润深度、脉管瘤栓和区域淋巴结转移与患者术后生存率有关;而性别、年龄、肿瘤大小、肿瘤位置、大体类型、分化程度与术后生存率无关。多因素分析显示,区域淋巴结转移是影响预后的独立危险因素。结论伴有区域淋巴结转移的早期胃癌患者预后较差,标准胃癌根治性手术后应接受综合治疗并严密随访。

Clinicopathological features of patients with early gastric cancer and analysis of prognosis

Objective To analyze the relationship between the prognosis and clinicopathologic features of patients with early gastric cancer.Methods Two hundred and fifty-five patients with early gastric cancer undergoing D2 lymphadenectomy from Jan 1994 to Oct 2005 were analyzed retrospectively,the clinicopathologic features and surgical outcome were examined.Survival rate was analyzed by Kaplan-Meier method,and compared by log rank test,prognostic factors were analyzed by multivariate COX proportional hazards model.Results Two hundred and fifty-five patients underwent D2 lymphadenectomy.The 5-year survival rate was 91.4%.The tumor infiltration,lymph node metastases and vascular invasion were significant prognostic factors regarding overall survival,but gender,age,the tumor size,the tumor site,the macroscopic type and the histological grade were not significant prognostic factors.Multivariate analysis indicated that the lymph node metastasis was independent poor prognostic factor.Conclusion Early gastric cancer patients with lymph node metastases have a relatively poor prognosis after standard surgery,they should accept comprehensive therapy after radical operation and strict follow-up.