新疆583例胃癌术后患者预后因素分析

摘要

Objective To evaluate the related factors for prognosis of gastric cancer patients after surgery and effect of postoperative adjuvant chemotherapy.Methods 583 gastric cancer patients from The Affilia-ted Tumor Hospital of Xinjiang Medical University after surgery between 2003 and 2008 were enrolled in this study.The survival rate was estimated by Kaplan-Meier method and compared with Log-rank method. Differences between different groups were compared by Chi-Square method.COX proportional hazards model was used for multivariate analysis.Results Single factor analysis shows that:the influencing factors in the 3-year survival rate of gastric cancer patients include preoperative CEA,tumor size,gross type,histological type,violation of depth,vascular invasion,lymph node dissection,TNM stage,com-bined chemotherapy or not,and time between operation (P <0.05).Further multivariate analysis shows that:the influencing factors in the 3-year survival independent prognosis include preoperative CEA,tumor size,gross type,histological type,violation of depth,vascular invasion,lymph node dissection,TNM stage (P <0.05).Conclusion In all the related factors affecting prognosis of gastric cancer,preoperative CEA,tumor size,gross type,histological type,violation of depth,vascular invasion,lymph node dissec-tion,TNM stage are independent prognostic factors.Postoperative adj uvant chemotherapy would improve the prognosis of gastric cancer and be suggested after operation.%目的：探讨胃癌患者根治术后预后的相关影响因素，评价胃癌根治术后辅助化疗的临床疗效及价值。方法选择2003－2008年首次入新疆医科大学附属肿瘤医院接受根治性手术的胃癌患者583例，对其临床资料进行回顾性分析并进行随访，应用KaPlan-Meier法进行生存分析，Log-rank法进行生存比较，检验进行组间对比， COX比例风险模型进行多因素分析。结果单因素分析示：术前 CEA、肿瘤大小、大体分型、组织学分级、浸润深度、区域淋巴结转移、脉管浸润、术后辅助化疗、病理分期9个因素是胃癌患者3年生存率的影响因素（P ＜0．05）；而性别、年龄、肿瘤部位则对3年生存率的影响差异无统计学意义（P ＞0．05）。多因素分析结果显示术前CEA、肿瘤大小、大体分型、组织学分级、浸润深度、区域淋巴结转移、脉管浸润、病理分期是影响生存的独立预后因素（P ＜0．05）。结论胃癌预后与多种因素密切相关。可根据术前CEA、肿瘤大小、大体分型、组织学分级、浸润深度、区域淋巴结转移、脉管浸润、病理分期判断预后，指导治疗。