中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2013年
10期
732-735
,共4页
焦旭光%梁寒%邓靖宇%王力%刘宏根%梁月祥
焦旭光%樑寒%鄧靖宇%王力%劉宏根%樑月祥
초욱광%량한%산정우%왕력%류굉근%량월상
胃肿瘤%肿瘤复发,局部%肿瘤转移%危险因素
胃腫瘤%腫瘤複髮,跼部%腫瘤轉移%危險因素
위종류%종류복발,국부%종류전이%위험인소
Stomach neoplasms%Neoplasm recurrence,local%Neoplasm metastasis%Risk factors
目的 探讨淋巴结转移阴性进展期胃癌根治术后复发的危险因素.方法 收集2001年1月至2008年12月间在天津医科大学肿瘤医院行胃癌根治术治疗、经病理确诊为淋巴结转移阴性腺癌且随访资料完整的胃癌患者共270例,依据术后复发与否分为复发组与未复发组.回顾性分析这两组病例的临床病理资料,总结影响淋巴结转移阴性进展期胃癌根治术后复发的危险因素.结果 全组共复发45例(16.7％),复发时间2 ～68个月,生存时间5～ 87个月.复发组与未复发组患者在肿瘤直径、肿瘤浸润深度、清扫阴性淋巴结数目相比差异均具有统计学意义(均P＜0.05).单因素分析显示:肿瘤直径、术后化疗与否与局部复发相关；肿瘤直径、浸润深度、术后化疗与远处转移相关.多因素分析显示,肿瘤直径、清扫阴性淋巴结数、浸润深度是全组复发的独立危险因素；浸润深度和清扫淋巴结数目是局部复发的独立危险因素；肿瘤直径、术后化疗是远处转移的独立危险因素.结论 对于T4期、肿瘤直径＞4 cm的淋巴结转移阴性胃癌,标准的淋巴结清扫能减少局部复发,术后辅助化疗能降低远处转移复发率.
目的 探討淋巴結轉移陰性進展期胃癌根治術後複髮的危險因素.方法 收集2001年1月至2008年12月間在天津醫科大學腫瘤醫院行胃癌根治術治療、經病理確診為淋巴結轉移陰性腺癌且隨訪資料完整的胃癌患者共270例,依據術後複髮與否分為複髮組與未複髮組.迴顧性分析這兩組病例的臨床病理資料,總結影響淋巴結轉移陰性進展期胃癌根治術後複髮的危險因素.結果 全組共複髮45例(16.7％),複髮時間2 ～68箇月,生存時間5～ 87箇月.複髮組與未複髮組患者在腫瘤直徑、腫瘤浸潤深度、清掃陰性淋巴結數目相比差異均具有統計學意義(均P＜0.05).單因素分析顯示:腫瘤直徑、術後化療與否與跼部複髮相關；腫瘤直徑、浸潤深度、術後化療與遠處轉移相關.多因素分析顯示,腫瘤直徑、清掃陰性淋巴結數、浸潤深度是全組複髮的獨立危險因素；浸潤深度和清掃淋巴結數目是跼部複髮的獨立危險因素；腫瘤直徑、術後化療是遠處轉移的獨立危險因素.結論 對于T4期、腫瘤直徑＞4 cm的淋巴結轉移陰性胃癌,標準的淋巴結清掃能減少跼部複髮,術後輔助化療能降低遠處轉移複髮率.
목적 탐토림파결전이음성진전기위암근치술후복발적위험인소.방법 수집2001년1월지2008년12월간재천진의과대학종류의원행위암근치술치료、경병리학진위림파결전이음성선암차수방자료완정적위암환자공270례,의거술후복발여부분위복발조여미복발조.회고성분석저량조병례적림상병리자료,총결영향림파결전이음성진전기위암근치술후복발적위험인소.결과 전조공복발45례(16.7％),복발시간2 ～68개월,생존시간5～ 87개월.복발조여미복발조환자재종류직경、종류침윤심도、청소음성림파결수목상비차이균구유통계학의의(균P＜0.05).단인소분석현시:종류직경、술후화료여부여국부복발상관；종류직경、침윤심도、술후화료여원처전이상관.다인소분석현시,종류직경、청소음성림파결수、침윤심도시전조복발적독립위험인소；침윤심도화청소림파결수목시국부복발적독립위험인소；종류직경、술후화료시원처전이적독립위험인소.결론 대우T4기、종류직경＞4 cm적림파결전이음성위암,표준적림파결청소능감소국부복발,술후보조화료능강저원처전이복발솔.
Objective To evaluate the risk factors for recurrence of node-negative advanced gastric cancer(N0-AGC) after radical resection.Methods Data of 270 N0-AGC cases after curative intent resection were collected from 2001 to 2008 in Tianjin Cancer Hospital.There were 45 cases with postoperative recurrence.Univariate and multivariate analysis were applied to investigate risk factors for postoperative recurrence.Results The recurrence time was 2-68 months,the survival time was 5-87 months.Univariate analysis showed that tumor size,depth of tumor invasion,number of negative lymph nodes were associated with recurrence of N0-AGC.Multivariate analysis identified tumor size,depth of tumor invasion,number of negative lymph nodes as independent recurrence factors for entire cohort,depth of tumor invasion,number of negative lymph nodes were risk factors for locoregional recurrence.Tumor size,adjuvant chemotherapy for hematogenous metastasis.Conclusions For T4 stage,tumor diameter ＞4 cm advanced node-negative gastric cancer patients,extended lymphadenectomy was recommended to decrease locoregional recurrence,and adjuvant chemotherapy to reduce hematogenous spread.
