CAJ | 학술논문

目的回顾性分析539例早期胃癌患者的临床病理学资料,探讨影响早期胃癌预后及复发的危险因素.方法收集2007年7月至2012年7月间青岛大学附属医院539例行胃癌根治术的早期胃癌患者的临床及随访资料.采用x2检验或Fisher确切概率法进行单因素分析,Logistic回归模型进行多因素分析,应用寿命表方法计算患者的5年生存率,Log-rank检验进行单因素分析,COX回归模型进行多因素分析.结果单因素分析表明,患者的年龄、胃癌分化程度、浸润深度、肿瘤直径、神经浸润、脉管浸润及N分期是影响早期胃癌复发的危险因素;多因素分析表明,N分期、脉管浸润及浸润深度是影响早期胃癌术后复发的独立危险因素(OR=12.144、11.753、3.142,均P＜0.05).单因素分析患者年龄、浸润深度、N分期、肿瘤直径与预后有关(均P＜0.05),多因素分析显示N分期和肿瘤直径是影响预后的独立因素(OR=8.275、1.359,均P＜0.05).结论早期胃癌预后良好,但是仍然存在一定比例的局部复发及远处转移.N分期、脉管浸润及浸润深度与早期胃癌复发有关,肿瘤直径、N分期与预后有关.
목적 회고성분석539례조기위암환자적림상병이학자료,탐토영향조기위암예후급복발적위험인소.방법 수집2007년7월지2012년7월간청도대학부속의원539례행위암근치술적조기위암환자적림상급수방자료.채용x2검험혹Fisher학절개솔법진행단인소분석,Logistic회귀모형진행다인소분석,응용수명표방법계산환자적5년생존솔,Log-rank검험진행단인소분석,COX회귀모형진행다인소분석.결과 단인소분석표명,환자적년령、위암분화정도、침윤심도、종류직경、신경침윤、맥관침윤급N분기시영향조기위암복발적위험인소;다인소분석표명,N분기、맥관침윤급침윤심도시영향조기위암술후복발적독립위험인소(OR=12.144、11.753、3.142,균P＜0.05).단인소분석환자년령、침윤심도、N분기、종류직경여예후유관(균P＜0.05),다인소분석현시N분기화종류직경시영향예후적독립인소(OR=8.275、1.359,균P＜0.05).결론 조기위암예후량호,단시잉연존재일정비례적국부복발급원처전이.N분기、맥관침윤급침윤심도여조기위암복발유관,종류직경、N분기여예후유관.
Objective To analyze the pathoclinical characteristics and to investigate the risk factors relating to prognosis and recurrence in 539 early gastric cancer (EGC) patients after radical gastrectomy.Methods The clinical data of 539 EGC patients undergoing radical surgery from July 2007 to July 2012 were analysed and patients were followed up.Univariate and multivariate analysis was performed by Chi-square test or Fisher's exact test and logistic regression respectively.5-year survival rate was calculated by life-table method.Log-rank test and Cox regression were used for univariate and multivariate analysis to determine the independent factors related to the prognosis of early gastric cancer after radical resection.Results Univariate analysis showed that age,degree of differentiation,depth of invasion,tumor size,neural involvement,vascular invasion and N staging were the risk factors for recurrence of early gastric cancer.Multivariate analysis revealed that N stage,depth of invasion and vascular invasion were the independent risk factors for postoperative relapse of the disease (OR =12.144,11.753,3.142,P ＜ 0.05).Univariate analysis indicated that age,depth of invasion,N stage and tumor size were related to patient's prognosis (P ＜ 0.05),multivariate analysis revealed that N stage,tumor diameter were the independent prognostic factor (OR =8.275,1.359,P ＜0.05).Conclusions N stage,vascular invasion and depth of invasion are associated with cancer recurrence,while N stage and tumor size are related to prognosis of EGC.