中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2014年
2期
139-144
,共6页
王玮%周志伟%詹友庆%李威%陈映波%孙晓卫%徐大志%李元方%关远祥
王瑋%週誌偉%詹友慶%李威%陳映波%孫曉衛%徐大誌%李元方%關遠祥
왕위%주지위%첨우경%리위%진영파%손효위%서대지%리원방%관원상
胃肿瘤%外科治疗%临床病理特征%预后%变迁
胃腫瘤%外科治療%臨床病理特徵%預後%變遷
위종류%외과치료%림상병리특정%예후%변천
Stomach neoplasms%Surgical treatment%Clinicopathologic characteristics%Prognosis%Changes
目的 探讨20年来胃癌临床病理特征及外科治疗效果的变迁.方法 回顾性分析中山大学肿瘤防治中心1990年1月至2009年12月期间行胃癌手术切除的2518例患者的临床病理资料,将其按入院时间段分为前阶段组(1990-1999年)和近阶段组(2000-2009年),比较两组患者的临床病理特征及生存差异.结果 全组患者5年生存率为48.1％,其中行根治性切除患者5年生存率为53.7％.前阶段组与近阶段组患者肿瘤大小、病理类型、脉管癌栓、T分期、N分期、TNM分期和淋巴结清扫数目的差异有统计学意义(均P＜0.05).对于根治性切除患者,近阶段组平均清扫淋巴结数目为(20.1±8.3)枚/例,明显多于近阶段组的(9.5±6.0)枚/例(P＜0.01).前阶段组和近阶段组患者5年生存率分别为40.1％和51.5％,其中根治性切除患者5年生存率分别为45.7％和57.1％,差异均有统计学意义(均P＜0.05).多因素预后分析证实,时间段是胃癌患者的独立预后因素(HR=0.763,95％CI:0.669～0.872).结论 与20世纪90年代相比,近10年来胃癌外科治疗效果得到了确切提高.
目的 探討20年來胃癌臨床病理特徵及外科治療效果的變遷.方法 迴顧性分析中山大學腫瘤防治中心1990年1月至2009年12月期間行胃癌手術切除的2518例患者的臨床病理資料,將其按入院時間段分為前階段組(1990-1999年)和近階段組(2000-2009年),比較兩組患者的臨床病理特徵及生存差異.結果 全組患者5年生存率為48.1％,其中行根治性切除患者5年生存率為53.7％.前階段組與近階段組患者腫瘤大小、病理類型、脈管癌栓、T分期、N分期、TNM分期和淋巴結清掃數目的差異有統計學意義(均P＜0.05).對于根治性切除患者,近階段組平均清掃淋巴結數目為(20.1±8.3)枚/例,明顯多于近階段組的(9.5±6.0)枚/例(P＜0.01).前階段組和近階段組患者5年生存率分彆為40.1％和51.5％,其中根治性切除患者5年生存率分彆為45.7％和57.1％,差異均有統計學意義(均P＜0.05).多因素預後分析證實,時間段是胃癌患者的獨立預後因素(HR=0.763,95％CI:0.669～0.872).結論 與20世紀90年代相比,近10年來胃癌外科治療效果得到瞭確切提高.
목적 탐토20년래위암림상병리특정급외과치료효과적변천.방법 회고성분석중산대학종류방치중심1990년1월지2009년12월기간행위암수술절제적2518례환자적림상병리자료,장기안입원시간단분위전계단조(1990-1999년)화근계단조(2000-2009년),비교량조환자적림상병리특정급생존차이.결과 전조환자5년생존솔위48.1％,기중행근치성절제환자5년생존솔위53.7％.전계단조여근계단조환자종류대소、병리류형、맥관암전、T분기、N분기、TNM분기화림파결청소수목적차이유통계학의의(균P＜0.05).대우근치성절제환자,근계단조평균청소림파결수목위(20.1±8.3)매/례,명현다우근계단조적(9.5±6.0)매/례(P＜0.01).전계단조화근계단조환자5년생존솔분별위40.1％화51.5％,기중근치성절제환자5년생존솔분별위45.7％화57.1％,차이균유통계학의의(균P＜0.05).다인소예후분석증실,시간단시위암환자적독립예후인소(HR=0.763,95％CI:0.669～0.872).결론 여20세기90년대상비,근10년래위암외과치료효과득도료학절제고.
Objective To investigate changes in clinicopathological features and survival of patients with gastrectomy at a single institution in China.Methods From January 1990 to December 2009,clinicopathological data of 2518 cases of gastric cancer patients who underwent surgical resection in the Sun Yat-sen Uinversity Cancer Center were analyzed retrospectively.The overall survival rate was determined using Kaplan-Meier method and log-rank test was used to determine significance.The prognosis was analyzed using univariate analysis and multivariate analysis by Cox proportional hazards model.Clinical features,pathological findings and survival differences were compared in this cohort between two consecutive periods(1990-1999 and 2000-2009).Results The 5-year survival rates for the whole cohort and those undergoing radical resection was 48.1％ and 53.7％,respectively.In the first period,the 5-year survival rate for the whole cohort and for patients undergoing radical resection was 40.1％ and 45.7％.In the second period,the 5-year survival rates for whole cohort and for patients undergoing radical resection was 51.5％ and 57.1％,respectively.For those who underwent radical resection,the mean number of lymph node dissection was significantly higher in the recent period (20.1±8.3 vs.9.5±6.0,P＜O.01).On multivariate analysis by means of the Cox proportional hazard model,age,location,tumor size,histological type,radical resection,lymphatic/venous invasion,depth of invasion,nodal status,number of retrieved lymph nodes,and treatment period were independent factors (P＜0.05).The constitution,number of retrieved lymph nodes,and survival rate were all improved between the two intervals (P＜0.05).Conclusion The overall survival rate has gradually increased in gastric cancer patients over the past 20 years.
