肿瘤直径对胃癌患者预后判断价值的分析  

The prognostic analysis of tumor size in gastric cancer patients

作　　者：张梅玲[1] 王建[1] 施伟[1] 卢凯华[1] 束永前[1] 刘平[1] 

机构地区：[1]南京医科大学第一附属医院肿瘤科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2011年第2期229-234,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省科技厅社会发展重点项目(BS2007011)

摘　　要：目的:探讨肿瘤直径对胃癌患者预后判断的价值。方法:回顾性分析在南京医科大学第一附属医院接受手术和化疗的胃癌患者共489例,通过统计学方法分析肿瘤直径对胃癌预后的影响。结果:影响患者生存的肿瘤直径最佳截断值是3 cm,据此将患者分为2组:小病灶组(small size group,SSG)直径<3 cm,大病灶组(large size group,LSG)直径≥3 cm,肿瘤直径与分化程度、神经脉管侵犯、浸润深度、淋巴结转移数目及TNM分期密切相关。单因素分析显示SSG组患者的中位生存时间及5年生存率明显优于LSG组患者。多因素COX回归分析显示肿瘤直径与大体分型、肿瘤浸润深度、淋巴结转移、远处转移情况均是影响胃癌患者生存的独立预后因素。T2、T3期SSG组患者生存率明显高于LSG组。结论:对于胃癌患者,肿瘤直径是判断预后重要的参数,可作为生存的独立预后因素。Objective： To investigate the prognostic significance of tumor size in patients with gastric cancer.Methods：To evaluate the influence of tumor size on the outcome,we reviewed 489 gastric cancer patients who underwent surgery and chemotherapy.Results：An appropriate cutoff value of tumor size affecting patient survival was 3 cm.Patients were divided into two groups as follows： small size group（SSG）with tumor size 〈3 cm,and large size group（LSG） with tumor size ≥3 cm.Tumor size was significantly related to histological grade,status of lymphovascular and vessel invasion,depth of primary tumor invasion,lymph node metastasis and TNM stage.Univariate analysis revealed that the prognosis of patients in SSG was significantly better than that in LSG.Multivariate analysis showed that tumor size was an independent prognostic factor along with macroscopic appearance,depth of primary tumor invasion,lymph node metastasis and distant metastasis.In SSG,patients with T2 and T3 had significant higher 5-year survival rate than those with T2 and T3 in LSG.Conclusion：Tumor size is one of highly significant parameters,served as independent predictor of survival in patients with gastric cancer.

关 键 词：胃癌 肿瘤直径 多因素分析 预后 

分 类 号：R735.2[医药卫生—肿瘤]