CAJ | 학술논문

目的探讨混合型组织学类型胃癌的临床病理特点以及预后分析.方法回顾性分析2003-2006年间在天津医科大学肿瘤医院接受根治性手术治疗、且临床病理资料完整的1108例胃癌患者的临床及随访资料.总结其中混合组织学类型胃癌的临床病理特点及预后.结果全组胃癌患者中,混合型胃癌144例(13.0％).与单一型胃癌临床病理特征比较,混合型胃癌肿瘤更大、T4期比例更高、更易发生淋巴结转移和远处转移、临床分期更晚(均P＜0.05).混合型胃癌患者3年和5年生存率分别为26.5％和10.8％,明显低于单一型胃癌患者的58.8％和35.0％(P＜0.01).单因素和多因素预后分析显示,TNM分期是影响混合型胃癌患者预后的独立因素(P＜0.01).在混合型胃癌中,高中分化癌加高中分化癌、高中分化癌加低分化癌和低分化癌加低分化癌患者5年生存率分别为19.5％、10.3％和7.6％,差异无统计学意义(P＞0.462).结论相对于单一组织学类型胃癌,混合型胃癌侵袭力更强,总体预后不佳;其组织学成分的不同并不会影响预后.
목적 탐토혼합형조직학류형위암적림상병리특점이급예후분석.방법 회고성분석2003-2006년간재천진의과대학종류의원접수근치성수술치료、차림상병리자료완정적1108례위암환자적림상급수방자료.총결기중혼합조직학류형위암적림상병리특점급예후.결과 전조위암환자중,혼합형위암144례(13.0％).여단일형위암림상병리특정비교,혼합형위암종류경대、T4기비례경고、경역발생림파결전이화원처전이、림상분기경만(균P＜0.05).혼합형위암환자3년화5년생존솔분별위26.5％화10.8％,명현저우단일형위암환자적58.8％화35.0％(P＜0.01).단인소화다인소예후분석현시,TNM분기시영향혼합형위암환자예후적독립인소(P＜0.01).재혼합형위암중,고중분화암가고중분화암、고중분화암가저분화암화저분화암가저분화암환자5년생존솔분별위19.5％、10.3％화7.6％,차이무통계학의의(P＞0.462).결론 상대우단일조직학류형위암,혼합형위암침습력경강,총체예후불가;기조직학성분적불동병불회영향예후.
Objective To evaluate the clinicopathologic characteristics and prognosis of mixed histological type (MHT)gastric cancer.Methods Clinical and follow-up data of 1108 gastric cancer patients undergoing radical operation in Tianjin Cancer Hospital between 2003 and 2006 were analyzed retrospectively.Clinicopathologic characteristics of MHT gastric cancer were summarized and the prognosis was analyzed by Kaplan-Meier analysis and COX regression.Results Among the 1108 patients,144(13.0％) had mixed histology type of gastric cancer.Compared to the unitary histological type (UHT),MHT gastric cancer had bigger tumor size,higher proportion of T4 tumor,and was easier for lymph node and distant metastasis (all P＜0.05).The 3.-and 5-year survival rates of patients with MHT were 26.5％ and 10.8％ respectively,which were lower than those with UHT (58.8％ and 35.0％,P＜0.01).Univariate and multivariate analyses showed TNM classification was an independent prognostic factor (P＜0.01).Conclusions MHT gastric cancer shows worse prognosis than UHT gastric cancer.There is no difference in prognosis among various combination of MHT gastric cancer.TNM classification is an independent prognostic factor of MHT gastric cancer.