中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2012年
2期
106-109
,共4页
刘辉%张汝鹏%李昉璇%权继传%梁寒
劉輝%張汝鵬%李昉璇%權繼傳%樑寒
류휘%장여붕%리방선%권계전%량한
胃肿瘤%淋巴瘤,非霍奇金%预后%因素分析,统计学
胃腫瘤%淋巴瘤,非霍奇金%預後%因素分析,統計學
위종류%림파류,비곽기금%예후%인소분석,통계학
Stomach neoplasms%Lymphoma,non-Hodgkin%Prognosis%Factor analysis,statistical
目的 探讨原发性胃淋巴瘤的临床病理特征和预后影响因素.方法 回顾分析1983年4月至2008年4月收治的204例原发性胃淋巴瘤患者的临床病理及随访资料.男性106例,女性98例,年龄19～85岁,平均年龄53.7岁.其中胃底病变41例(20.1％)、胃体病变127例(62.3％)、胃窦病变105例(51.5％)、贲门病变13例(6.4％)、十二指肠球部病变1例(0.5％),分析患者临床特征及其对预后的影响.结果 本组患者临床症状多以腹痛(62.3％)、体质量减轻(52.9％)为主,胃镜下多表现为溃疡型(76.0％),单部位受累多见(62.7％),其细胞分级以低、中度恶性为主(179/204,87.7％),临床分期以Musshoff Ⅰ、Ⅱ期为主(74.0％).在有完整随访资料的186例患者中,其1、3、5年生存率分别为75.8％、63.4％、60.2％,总体中位生存期50.0个月.单因素分析中年龄(x2=5.030)、乳酸脱氢酶水平(x2=40.084)、细胞分级(x2=35.238)、Musshoff分期(x2=71.601)、肿瘤直径(x2=12.018)以及治疗方式(x2 =14.140)是影响预后的相关因素(P＜0.05).多因素分析证实Musshoff分期(RR=2.230,95％ CI:1.372～3.625)、细胞分级(RR=1.892,95％ CI:1.010～3.543)是影响预后的独立因素(P＜0.05)；Ⅰ、Ⅱ期患者手术与单纯化疗效果差异不大(x2=1.223,P=0.542).结论 Musshoff分期、细胞的恶性程度是影响预后的独立因素,对于Ⅰ、Ⅱ期的原发性胃淋巴瘤患者,外科手术治疗不再是首选的治疗措施.
目的 探討原髮性胃淋巴瘤的臨床病理特徵和預後影響因素.方法 迴顧分析1983年4月至2008年4月收治的204例原髮性胃淋巴瘤患者的臨床病理及隨訪資料.男性106例,女性98例,年齡19～85歲,平均年齡53.7歲.其中胃底病變41例(20.1％)、胃體病變127例(62.3％)、胃竇病變105例(51.5％)、賁門病變13例(6.4％)、十二指腸毬部病變1例(0.5％),分析患者臨床特徵及其對預後的影響.結果 本組患者臨床癥狀多以腹痛(62.3％)、體質量減輕(52.9％)為主,胃鏡下多錶現為潰瘍型(76.0％),單部位受纍多見(62.7％),其細胞分級以低、中度噁性為主(179/204,87.7％),臨床分期以Musshoff Ⅰ、Ⅱ期為主(74.0％).在有完整隨訪資料的186例患者中,其1、3、5年生存率分彆為75.8％、63.4％、60.2％,總體中位生存期50.0箇月.單因素分析中年齡(x2=5.030)、乳痠脫氫酶水平(x2=40.084)、細胞分級(x2=35.238)、Musshoff分期(x2=71.601)、腫瘤直徑(x2=12.018)以及治療方式(x2 =14.140)是影響預後的相關因素(P＜0.05).多因素分析證實Musshoff分期(RR=2.230,95％ CI:1.372～3.625)、細胞分級(RR=1.892,95％ CI:1.010～3.543)是影響預後的獨立因素(P＜0.05)；Ⅰ、Ⅱ期患者手術與單純化療效果差異不大(x2=1.223,P=0.542).結論 Musshoff分期、細胞的噁性程度是影響預後的獨立因素,對于Ⅰ、Ⅱ期的原髮性胃淋巴瘤患者,外科手術治療不再是首選的治療措施.
목적 탐토원발성위림파류적림상병리특정화예후영향인소.방법 회고분석1983년4월지2008년4월수치적204례원발성위림파류환자적림상병리급수방자료.남성106례,녀성98례,년령19～85세,평균년령53.7세.기중위저병변41례(20.1％)、위체병변127례(62.3％)、위두병변105례(51.5％)、분문병변13례(6.4％)、십이지장구부병변1례(0.5％),분석환자림상특정급기대예후적영향.결과 본조환자림상증상다이복통(62.3％)、체질량감경(52.9％)위주,위경하다표현위궤양형(76.0％),단부위수루다견(62.7％),기세포분급이저、중도악성위주(179/204,87.7％),림상분기이Musshoff Ⅰ、Ⅱ기위주(74.0％).재유완정수방자료적186례환자중,기1、3、5년생존솔분별위75.8％、63.4％、60.2％,총체중위생존기50.0개월.단인소분석중년령(x2=5.030)、유산탈경매수평(x2=40.084)、세포분급(x2=35.238)、Musshoff분기(x2=71.601)、종류직경(x2=12.018)이급치료방식(x2 =14.140)시영향예후적상관인소(P＜0.05).다인소분석증실Musshoff분기(RR=2.230,95％ CI:1.372～3.625)、세포분급(RR=1.892,95％ CI:1.010～3.543)시영향예후적독립인소(P＜0.05)；Ⅰ、Ⅱ기환자수술여단순화료효과차이불대(x2=1.223,P=0.542).결론 Musshoff분기、세포적악성정도시영향예후적독립인소,대우Ⅰ、Ⅱ기적원발성위림파류환자,외과수술치료불재시수선적치료조시.
Objective To explore the clinicopathological characteristics and prognostic factors of primary gastric lymphoma(PGL).Methods The clinical data of 204 patients with PGL was reviewed and analyzed.There were 106 males and 98 females,their age were 19 to 85 years(average age was 53.7 years).The Focal areas included gastric fundus lesions 41 cases(20.1％),stomach body lesions 127 cases (62.3％),distal gastric lesions 105 cases(51.5％),cardia lesions 13 cases(6.4％),duodenal bulb lesion 1 cases(0.5％).The clinical characteristics and the outcomes in patients with influence were analysed.Results In 204 PGL patients,the most common complaints were abdominal pain(62.3％)and weight loss(52.9％).Most of the PGL patients appeared ulcerative(76.0％)and results showed that 62.7％ patients involved single location.As to the factors of cellulate grading and pathological characteristics,most patients(87.7％)show low-grade or intermediate-grade lymphoma,Musshoff stages Ⅰ and Ⅱ(74.0％).In 186 patients with complete follow-up data,survival rates of 1-,3-and 5-year were 75.8％,63.4％ and 60.2％ respectively.The median overall survival time was 50.0 months.In univariate survival analysis,age(x2 =5.030),level of LDH(x2 =40.084),cellulate grading(x2 =35.238),Musshoff stage(x2 =71.601),tumor diameter(x2 =12.018)and option of managements(x2 =14.140)were obviously correlated with the prognosis(all P ＜ 0.05).Musshoff stage(RR =2.230,95％ CI:1.372-3.625)and cellulate grading(RR =1.892,95％ CI:1.010-3.543)were independent prognostic factors in multivariable analysis(both P ＜ 0.05).There was no prognostic difference between surgery and chemotherapy in stage Ⅰ and Ⅱ(x2 =1.223,P =0.542).Conclusions Musshoff stage and grade malignancy are independent prognostic factors.For patients with stage Ⅰ and Ⅱ,surgical resection is not the first-choice for clinical therapy.
