CAJ | 학술논문

目的：探讨影响食管胃结合部腺癌（adenocarcinoma of the esophagogastric junction，AEG）患者预后的相关因素，以期指导临床工作。方法回顾性分析我院普外科2004年1月～2006年12月行手术治疗且经病理确诊为胃食管结合部腺癌的181例患者的临床病历资料，统计分析患者的临床相关因素对预后的影响。结果全组1、3、5年总的生存率分别为83．4％，55．2％，30．9％。通过分析得出3种AEG分型患者术后生存差异无统计学意义（P＞0．05），而与年龄、肿瘤浸润深度、是否淋巴结转移和远处转移、组织学分化程度、是否侵犯胃壁神经及临床TNM分期差异有统计学意义（P＜0．05）。Cox多因素分析显示，肿瘤浸润深度和淋巴结转移是影响患者术后生存的独立因素（P＜0．05）。结论患者预后与不同Siewert分型及性别无明显相关，与年龄、肿瘤浸润深度、是否淋巴结转移和远处转移、组织学分化程度、是否侵犯胃壁神经及临床TNM分期存在相关，其中肿瘤的浸润深度及淋巴结转移是影响AEG术后生存的独立因素。
목적：탐토영향식관위결합부선암（adenocarcinoma of the esophagogastric junction，AEG）환자예후적상관인소，이기지도림상공작。방법회고성분석아원보외과2004년1월～2006년12월행수술치료차경병리학진위위식관결합부선암적181례환자적림상병력자료，통계분석환자적림상상관인소대예후적영향。결과전조1、3、5년총적생존솔분별위83．4％，55．2％，30．9％。통과분석득출3충AEG분형환자술후생존차이무통계학의의（P＞0．05），이여년령、종류침윤심도、시부림파결전이화원처전이、조직학분화정도、시부침범위벽신경급림상TNM분기차이유통계학의의（P＜0．05）。Cox다인소분석현시，종류침윤심도화림파결전이시영향환자술후생존적독립인소（P＜0．05）。결론환자예후여불동Siewert분형급성별무명현상관，여년령、종류침윤심도、시부림파결전이화원처전이、조직학분화정도、시부침범위벽신경급림상TNM분기존재상관，기중종류적침윤심도급림파결전이시영향AEG술후생존적독립인소。
Objective To analyze the related prognostic factors with adenocarcinoma of the esophagogastric junction (AEG),in the hope of guiding the clinical work.Methods The clinical data of 181 cases of AEG who underwent surgical treatment in our hospital from Jan-uary 2004 to December 2006 were retrospectively studied.The clinical relevant factors on prognosis were statistically analyzed.Results The overall survival rates in the first,third and fifth year were 83.4%,55.2%,and 30.9% respectively.By analyzing the prognosis about three types of AEG,there was no significant difference in survival (P>0.05).But age,depth of invasion,lymph node metastasis and distant metas-tasis,histological differentiation grade,neural invasion and clinical TNMstaging had significant difference in survival (P<0.05).Multivariate analysis showed that depth of invasion and lymph node metastasis were independent prognostic factors(P<0.05).Conclusion The progno-sis of patients has no significant correlation with different Siewert type and gender,but is related with age,depth of invasion,lymph node me-tastasis and distant metastasis,histological differentiation grade,neural invasion and clinical TNM stage.The depth of invasion and lymph node metastasis are independent prognostic factors of AEG.