胃食管结合部腺癌预后的影响因素分析

摘要

Objectives To clarify the important clinicopathological and therapeutical factors affecting the prognosis of patients with gastroesophageal junction carcinoma. Methods: Collected surgical resection and the pathology inspection confirmed 147 cases of gastroesophageal junction carcinoma from Shandong University affiliated provincial hospital during January 2006 to August 2007, followed up to 2012. Used the telephone follow-up way, acquired the 5 years treatments and prognosis, and made use of SPSS17.0 for survival analysis. Results: 1, 3 and 5 years survival rate was 79.3%, 54% and 40.6% , median survival time was 36 months. The single factor K - M analysis: gender(P=0.000), age(P=0.047), TNM stage(P=0.000), pathological detection lymph node num-ber(P=0.038), lymph node status(P=0.000), tissue differentiation degree(P=0.010), chemotherapy (P=0.003)was the factors affecting the prognosis of gastroesophageal junction carcinoma. Multiple-factor Cox analysis: TNM staging(RR=1.928), chemotherapy(RR=0.523) was independent factors that affected the prognosis of gastroesophageal junction carcinoma. Conclusion; TNM staging is risk factors the prognosis, chemotherapy is the protective factors.%目的:探讨影响胃食管结合部腺癌术后患者预后的相关因素.方法:收集山东大学附属省立医院2006年1月-2007年8月手术切除并经病理证实同时具有完整随访资料的胃食管结合部腺癌标本147例,随访至2012年8月,采集患者5年内治疗和预后情况,运用SPSS17.0进行生存分析.结果:所纳入分析的胃食管结合部腺癌患者1、3和5年存活率分别是79.3％、54.0％和40.6％,中位生存时间36.0个月.运用单因素Kaplan-Meier分析:性别(P=0.000)、年龄(P=0.047)、TNM分期(P=0.000)、清除淋巴结数目(P=0.038)、淋巴结转移状态(P=0.000)、组织分化程度(P=0.010)、是否化疗(P=0.003)为影响预后的因素.多因素Cox分析:TNM分期(RR=1.928,P=0.000)、是否化疗(RR =0,523,P=0.017)是影响预后的独立因素.结论:在影响胃癌术后预后的相关因素中,TNM分期可作为预后的危险性因素,术后化疗作为保护性因素值得进一步深入分析.