混合组织学类型胃癌临床病理特点及预后分析  

Analysis of clinicopathologic characteristics and prognosis on mixed histology type of gastric cancer

作　　者：焦旭光[1] 梁寒[1] 邓靖宇[1] 王力[1] 刘宏根[1] 梁月祥[1] 

机构地区：[1]天津医科大学附属肿瘤医院胃部肿瘤科天津市肿瘤防治重点实验室,300060

出　　处：《中华胃肠外科杂志》2013年第3期260-263,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：国家重点研究发展计划973计划（2010CB529301）

摘　　要：目的探讨混合型组织学类型胃癌的临床病理特点以及预后分析。方法回顾性分析2003—2006年间在天津医科大学肿瘤医院接受根治性手术治疗、且临床病理资料完整的1108例胃癌患者的临床及随访资料。总结其中混合组织学类型胃癌的临床病理特点及预后。结果全组胃癌患者中，混合型胃癌144例（13．0％）。与单一型胃癌临床病理特征比较，混合型胃癌肿瘤更大、T4期比例更高、更易发生淋巴结转移和远处转移、临床分期更晚（均P〈0．05）。混合型胃癌患者3年和5年生存率分别为26．5％和10．8％，明显低于单一型胃癌患者的58．8％和35．0％（P〈0．01）。单因素和多因素预后分析显示，TNM分期是影响混合型胃癌患者预后的独立因素（P〈0．01）。在混合型胃癌中，高中分化癌加高中分化癌、高中分化癌加低分化癌和低分化癌加低分化癌患者5年生存率分别为19．5％、10．3％和7．6％，差异无统计学意义（P〉0．462）。结论相对于单一组织学类型胃癌，？昆合型胃癌侵袭力更强，总体预后不佳：其组织学成分的不同并不会影响预后。Objective To evaluate the clincopathologic characteristics and prognosis of mixed histological type （MHT）gastric cancer. Methods Clinical and follow-up data of 1108 gastric cancer patients undergoing radical operation in Tianjin Cancer Hospital between 2003 and 2006 were analyzed retrospectively. Clinicopathologic characteristics of MHT gastric cancer were summarized and the prognosis was analyzed by Kaplan-Meier analysis and COX regression. Results Among the 1108 patients, 144（13.0%） had mixed histology type of gastric cancer. Compared to the unitary histological type （UHT）, MHT gastric cancer had bigger tumor size, higher proportion of T4 tumor, and was easier for lymph node and distant metastasis （all P〈0.05）. The 3- and 5-year survival rates of patients with MHT were 26.5% and 10.8% respectively, which were lower than those with UHT （58.8% and 35.0%, P〈0.01）. Univariate and multivariate analyses showed TNM classification was an independent prognostic factor （P〈0.01）. Conclusions MHT gastric cancer shows worse prognosis than UHT gastric cancer. There is no difference in prognosis among various combination of MHT gastric cancer. TNM classification is an independent prognostic factor of MHT gastric cancer.

关 键 词：胃肿瘤 组织学类型 肿瘤分化 预后 

分 类 号：R735.2[医药卫生—肿瘤]