CAJ | 학술논문

目的：探讨不同部位胃癌患者根治术的临床病理特点及其对预后的影响。方法回顾性分析行胃癌根治术的胃癌患者168例的临床资料，将患者根据肿瘤部位分为胃上部癌（42例）、胃中部癌（57例）、胃下部癌（69例）三组，并对其临床病理特点、预后进行比较。结果胃上部癌男性患者比例较高（78．6％），平均年龄亦较中、下部癌高；上部癌、中部癌、下部癌中肿瘤直径≥4 cm的分别占71．4％、49．1％、29．0％（P＜0．05）；上部癌的全胃切除、联合脏器切除的比例显著高于中部、下部癌（P＜0．05）；术后3年，上部癌的生存率明显低于中部癌和下部癌（P＜0．05）；多因素Logistic回归分析显示，淋巴结转移、TNM分期高、上部癌均是胃癌术后生存的独立危险因素（均P＜0．05）。结论胃上部癌与中、下部癌临床病理特征明显不同，且其预后较差，结合肿瘤生长部位并据此选择合理的术式有助于改善患者预后，提高生存率。
목적：탐토불동부위위암환자근치술적림상병리특점급기대예후적영향。방법회고성분석행위암근치술적위암환자168례적림상자료，장환자근거종류부위분위위상부암（42례）、위중부암（57례）、위하부암（69례）삼조，병대기림상병리특점、예후진행비교。결과위상부암남성환자비례교고（78．6％），평균년령역교중、하부암고；상부암、중부암、하부암중종류직경≥4 cm적분별점71．4％、49．1％、29．0％（P＜0．05）；상부암적전위절제、연합장기절제적비례현저고우중부、하부암（P＜0．05）；술후3년，상부암적생존솔명현저우중부암화하부암（P＜0．05）；다인소Logistic회귀분석현시，림파결전이、TNM분기고、상부암균시위암술후생존적독립위험인소（균P＜0．05）。결론위상부암여중、하부암림상병리특정명현불동，차기예후교차，결합종류생장부위병거차선택합리적술식유조우개선환자예후，제고생존솔。
Objective To explore the clinicopathological features of radical gastrectomy for gastric cancer at different sites and analyze its impact on prognosis.Methods The clinical data of 168 casesof gastric carcinoma were restrospectively reviewed.According to the lesion sites,patients were divided into3 groups:the upper portion group(42 cases),middle portion group(57 cases)and lower portion group(69cases).Their clinicopathological features and prognosis were compared.Results In the upper portiongroup,the percentage of male patient was relatively greater and their average age was higher than the othergroups.The porpotions of large tumor size(diameter >4 cm)were 71.4%,49.1% and 29.0% in the upper,middle and lower portion group,respectively(P <0.05).The ratio of total gastrectomy and combinedmultiple organs resection in was higher than the other groups(P <0.05).At the 3rd year after surgery,thesurvival rate in the upper portion group was significantly lower than the other groups(P <0.05).Multiplelogistic regression analysis revealed that lymphatic metastasis,TNM stage,upper portion were the independent risk factors of postoperative survival of gastric cancer(P <0.05).Conclusion The clinicopathological features of the upper gastric cancer are quite different from the middle and lower cancer,and itsprognosis is poorer.According to the lesion sites,selecting reasonable surgical procedures is contribute toimprove the prognosis and survival rate.