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    癌结节在进展期胃癌患者预后中的价值及其危险因素

    Analysis of value andrisk factors of tumor deposit in prognosis of advanced gastric cancer

    • 摘要: 目的 探讨癌结节在进展期胃癌患者预后中的价值及其危险因素。方法 回顾性分析2013年3月至2017年1月在徐州医科大学附属医院行胃癌根治术的183例进展期胃癌患者的临床病理资料及随访资料。统计癌结节阳性率,分析癌结节阳性与患者临床病理特征的关系及其危险因素,进展期胃癌的预后分析,比较癌结节阳性与阴性患者术后无病生存期差异。结果 183例进展期胃癌患者中癌结节阳性者39例(21.3%)。单因素分析显示患者TNM分期(P<0.001)、脉管侵犯(P=0.018)及淋巴结转移(P<0.001)与癌结节有关,Logistic多因素分析显示,TNM分期(P=0.010)是癌结节阳性的独立危险因素。进展期胃癌的单因素预后分析显示分化程度(P=0.009)、肿瘤大小(P=0.002)、癌结节数目(P<0.001)、浸润深度(P<0.001)、淋巴结转移(P<0.001)、TNM分期(P<0.001)、脉管侵犯(P=0.001)、神经浸润(P=0.046)、术前CEA(P<0.001)、术后化疗(P=0.001)与进展期胃癌预后有关。COX多因素分析显示癌结节数目(P<0.001)、淋巴结转移(P=0.011)、术后化疗(P<0.001)、脉管侵犯(P=0.021)、术前CEA(P=0.003)是影响进展期胃癌预后的独立危险因素。结论 癌结节数目是进展期胃癌预后的独立危险因素。TNM分期越晚,癌结节阳性率越高,预后越差。

       

      Abstract: Objective To explore the value and risk factors of tumor deposit in prognosis of advanced gastric cancer . Methods Clinicopathological characteristics and follow-up date of 183 cases with advanced gastric cancer undergoing radical gastrectomy from March 2013 to January 2017 in Xuzhou Medical University Hospital were analyzed retrospectively. The positive rate of tumor deposit was statistically analyzed. Association of tumor deposit with clinicopathological characteristics and the risk factors. Prognostic difference between positive tumor deposit group and negative tumor deposit group was examined. Results Univariate analysis showed that TNM staging (P<0.001),vessel invasion (P=0.018)and lymph node metastasis(P<0.001)were closely associated with tumor deposit. Logistic multivariate analysis showed that TNM staging (P=0.010) was an independent risk factor for positive tumor deposit. The results of univariate analysis indicated that tumor differentiation (P=0.009), tumor size (P=0.002), the number of tumor deposits (P<0.001), invasion depth (P<0.001), lymph node metastasis (P<0.001), TNM staging (P<0.001), vessel invasion (P=0.001), neural invasion (P=0.046), preoperative CEA level (P<0.001) and postoperative chemotherapy (P=0.001) were found to be significantly associated with the prognosis of advanced gastric cancer. Multivariate analysis showed that the number of tumor deposits (P<0.001), lymph node metastasis (P=0.011), postoperative chemotherapy (P<0.001), vessel invasion (P=0.021) and preoperative CEA level (P=0.003) were independent risk factors for the prognosis of advanced gastric cancer. Conclusions The number tumor deposits may be an independent risk factor for the prognosis of advanced gastric cancer. The TNM staging is late, the positive of cancer nodules may be large and the prognosis is worse.

       

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