CAJ | 학술논문

目的揭示影响贲门腺癌手术预后的临床病理特征和危险因素.方法收集2009年6月-201 1年8月52例外科手术且随访资料完整的贲门癌患者的临床资料.对可能影响患者预后的因素进行单因素、多因素分析及生存风险分析.结果 1、2、3年生存率为73％、54％、46％.单因素分析显示T分期、N分期、TNM分期、Siewert classification、MSLN、静脉浸润与预后之间存在明显的相关性.逐步Cox比例风险模型显示T分期、N分期、MSLN是独立的危险因素.腹膜、肝脏是复发转移主要途径,腹膜转移与T分期、淋巴管浸润有关;而肝脏转移与MSLN有关.Kaplan-Meier法患者的生存曲线表明肝转移及腹膜转移患者生存期明显缩短.结论规范化的淋巴结清扫是影响预后关键因素,D2手术应该是贲门癌手术根治的标准.
목적 게시영향분문선암수술예후적림상병리특정화위험인소.방법 수집2009년6월-201 1년8월52예외과수술차수방자료완정적분문암환자적림상자료.대가능영향환자예후적인소진행단인소、다인소분석급생존풍험분석.결과 1、2、3년생존솔위73％、54％、46％.단인소분석현시T분기、N분기、TNM분기、Siewert classification、MSLN、정맥침윤여예후지간존재명현적상관성.축보Cox비례풍험모형현시T분기、N분기、MSLN시독립적위험인소.복막、간장시복발전이주요도경,복막전이여T분기、림파관침윤유관;이간장전이여MSLN유관.Kaplan-Meier법환자적생존곡선표명간전이급복막전이환자생존기명현축단.결론 규범화적림파결청소시영향예후관건인소,D2수술응해시분문암수술근치적표준.
Objective To evaluate the clinical and pathological characteristics and risk factors of the prognosis of Cardia cancer.Methods Clinical data of 52 cases of cardiac cancer patients who were treated by surgery and follow-up data were collected from June 2009 to August 2011.Factors influencing the prognosis of the patients were analyzed by univariate and multivariate analysis.Results The survival rates in 1,2,3years were 73％,54％,46％.Single factor analysis showed that there was a significant correlation between T stage,N stage,TNM stage,classification Siewert,MSLN and venous invasion.Stepwise Cox proportional hazard model showed that T stage,N stage and MSLN were independent risk factors.Peritoneal and liver were the main way of recurrence and metastasis.Peritoneal metastasis was related to T stage and lymph node invasion,while the liver metastasis was related to MSLN.The survival curves of patients with Kaplan-Meier showed that the survival period of patients with liver metastasis and peritoneal metastasis was significantly shortened.Conclusion Standardization of lymph node cleaning is a key factor affecting prognosis,D2 surgery should be an operation standard in cardia cancer.