新疆306例老年胃癌患者临床病理特征及预后分析

摘要

目的：探讨老年胃癌的临床病理特点及影响预后的相关因素。方法：回顾性分析306例老年胃癌患者临床病理资料，采用Kaplan-meier法计算患者的生存率，Log-rank检验进行单因素分析，Cox多因素回归分析与胃癌相关指标的预后意义。结果：随访的306胃癌患者中，存活123例，死亡183例，1、3、5年总体生存率分别为78.9％、43.2％、28.6％；单因素分析显示年龄、性别、民族、合并症、组织学分级、浸润深度、脉管及神经受侵、淋巴结转移、远处转移、肿瘤标志物与胃癌的预后相关（ P＜0.05）；吸烟史、肿瘤家族史、幽门螺杆菌（Hp）感染史、肿瘤部位、甲胎蛋白（AFP）与胃癌的预后无显著影响（P＞0.05）。Cox多因素分析结果显示年龄、合并症、饮酒史、脉管侵犯、浸润深度、淋巴结转移、pTNM分期、根治性手术是影响胃癌预后的独立危险因素。结论：年龄、合并症、饮酒史、脉管侵犯、浸润深度、淋巴结转移、pTNM分期、根治性手术是影响老年胃癌预后的独立危险因素；而pTNM分期反映肿瘤的生物学特性和进展状况，临床应用价值较高。%Objective:To explore the clinicopathological characteristics and the factors influencing the prognosis of gastric cancer in aged patients. Methods:Collected data of 306 patients with gastric cancer,confirmed by the histopa-thology in the First Affiliated Hospital of Xinjiang Medical University. Kaplan-meier and Cox regression were used to e-valuate the overall survival rate of patients and the prognostic significance of factors related to gastric cancer . Results:Of 306 cases followed up,123 still alive and 183 died,the overall survival rates for 1,3 and 5 years were 78. 9%,43. 2%, 28. 6%. The result of univariate analysis showed that age,complications,depth of invasion,histological grade,vascular and nerve,lymph node metastasis,distant metastasis,pTNM stage and radical surgery were related to prognosis of gas-tric cancer,while gender,tumor site nation,family history of cancer,Hp infection had no relationship. The Cox multi-variate analysis showed that age,complications,radical surgery,depth of invasion,lymph node metastasis and pTNM stage were independent prognostic factors. Conclusion:Many factors affect the prognosis of gastric cancer,in which age,complications,radical surgery,depth of invasion,lymph node metastasis and pTNM stage were independent prog-nostic factors. The pTNM stage have a high clinical value,which reflects the biological characteristics and the progress of the tumor.