胃上部癌与胃下部癌临床病理特点及预后的对比分析  

Comparision of clinicopathologic characters and prognosis between upper and lower part gastric carcinoma

作　　者：刘峥嵘[1] 张静[2] 鲁翀[1] 李国胜[3] 王红岩[3] 徐惠绵[1] 

机构地区：[1]中国医科大学附属第一医院肿瘤外科,辽宁沈阳110001 [2]中国医科大学附属第一医院内分泌科,辽宁沈阳110001 [3]辽宁省人民医院普通外科,辽宁沈阳110016

出　　处：《中国普通外科杂志》2008年第4期299-302,共4页China Journal of General Surgery

基　　金：国家自然科学基金资助项目(30672050)

摘　　要：目的对比分析胃上部癌与胃下部癌临床病理特点及预后。方法回顾性分析1999年1月—2003年12月手术切除的胃上部癌(U组)73例,胃下部癌(L组)366例的临床病理资料。结果U组男性多于女性(P<0.01);肿块直径大于5cm者U组明显多于L组(P<0.05);团块性生长L组明显多于U组(P<0.05),而弥漫性生长者U组明显多于L组(P<0.05);U组中早期胃癌病例数明显少于L组(P<0.01);U组中T1期明显少于L组(P<0.01),而T3和T4期明显多于L组(P<0.05);U组中N2+N3淋巴结转移阳性病例明显多于L组(P<0.05);U组以低、未分化型癌为主,且明显多于L组(P<0.05);U组的手术根治度多以B级和C级为主,A级明显少于L组(P<0.05);U组中位生存期为42个月,L组中位生存期为60个月;U组5年生存率明显低于L组(P<0.01),两组生存曲线比较有显著差异(P<0.01)。结论与胃下部癌比较,胃上部癌男性多于女性,肿块大、病期晚,以弥漫型生长,分级程度低为主要病理生物学特点;手术方式以相对根治和姑息切除为多,绝对根治者少,生存率低。因此,对胃上部癌治疗应采取以手术为主的综合治疗。Objective To compare the clinicopathologic characters and survival rates between upper and lower part gastric carcinoma. Methods The clinicopathologic data of 73 patients with upper part gastric carcinoma （group U） and 366 patients with lower part gastric carcinoma （group L ） were analyzed retrospectively. Results The clinicopathologic characteristics in group U were more male patients （ P 〈 0.01 ） , more tumor diameter larger than 5 cm（ P 〈 0.05 ） , more diffused tumor growth （ P 〈 0.05 ） , more T3 and T4 stages （ P 〈 0. 05 ） , more N2 ＋ N3 stage （ P 〈 0. 05 ） , more undifferentiated type （ P 〈 0. 05 ） and less patients with degree A excision （ P 〈 0.05 ） than those in group L. Median survival time was 42 months in group U and 60 months in group L, and 5-year survival rate in group U was significantly lower than that in group L （P 〈0.01 ）. Conclusions The patients in guoup U showed many differences compared with patients in group L, including more male patients, larger tumor diameter, diffused tumor growth, less early stage, later TNM stage, more lymph node metastasis, more undifferentiated type, and less radical operation. The survival rate in group U was significantly lower than in group L. Accordingly, the main treatment for the upper gastric carcinoma should be surgical excision as chief component of combined therapy.

关 键 词：胃肿瘤/外科学 胃上部癌 胃下部癌 对比研究 

分 类 号：R735.2[医药卫生—肿瘤]