淋巴结转移阴性进展期胃癌术后复发危险因素分析  

Risk factors for recurrence after radical resection of node-negative advanced 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：《中华普通外科杂志》2013年第10期732-735,共4页Chinese Journal of General Surgery

基　　金：国家重点研究发展计划973计划资助项目f2010CB529301）

摘　　要：目的 探讨淋巴结转移阴性进展期胃癌根治术后复发的危险因素.方法 收集2001年1月至2008年12月间在天津医科大学肿瘤医院行胃癌根治术治疗、经病理确诊为淋巴结转移阴性腺癌且随访资料完整的胃癌患者共270例,依据术后复发与否分为复发组与未复发组.回顾性分析这两组病例的临床病理资料,总结影响淋巴结转移阴性进展期胃癌根治术后复发的危险因素.结果 全组共复发45例（16.7％）,复发时间2 ～68个月,生存时间5～ 87个月.复发组与未复发组患者在肿瘤直径、肿瘤浸润深度、清扫阴性淋巴结数目相比差异均具有统计学意义（均P＜0.05）.单因素分析显示：肿瘤直径、术后化疗与否与局部复发相关；肿瘤直径、浸润深度、术后化疗与远处转移相关.多因素分析显示,肿瘤直径、清扫阴性淋巴结数、浸润深度是全组复发的独立危险因素；浸润深度和清扫淋巴结数目是局部复发的独立危险因素；肿瘤直径、术后化疗是远处转移的独立危险因素.结论 对于T4期、肿瘤直径＞4 cm的淋巴结转移阴性胃癌,标准的淋巴结清扫能减少局部复发,术后辅助化疗能降低远处转移复发率.Objective To evaluate the risk factors for recurrence of node-negative advanced gastric cancer（N0-AGC） after radical resection.Methods Data of 270 N0-AGC cases after curative intent resection were collected from 2001 to 2008 in Tianjin Cancer Hospital.There were 45 cases with postoperative recurrence.Univariate and multivariate analysis were applied to investigate risk factors for postoperative recurrence.Results The recurrence time was 2-68 months,the survival time was 5-87 months.Univariate analysis showed that tumor size,depth of tumor invasion,number of negative lymph nodes were associated with recurrence of N0-AGC.Multivariate analysis identified tumor size,depth of tumor invasion,number of negative lymph nodes as independent recurrence factors for entire cohort,depth of tumor invasion,number of negative lymph nodes were risk factors for locoregional recurrence.Tumor size,adjuvant chemotherapy for hematogenous metastasis.Conclusions For T4 stage,tumor diameter 〉4 cm advanced node-negative gastric cancer patients,extended lymphadenectomy was recommended to decrease locoregional recurrence,and adjuvant chemotherapy to reduce hematogenous spread.

关 键 词：胃肿瘤 肿瘤复发 局部 肿瘤转移 危险因素 

分 类 号：R735.2[医药卫生—肿瘤]