1034例胃癌的临床及病理学分析  

Clinical and Pathological Study of Gastric Cancer in 1 034 Patients

作　　者：牛伟新[1] 逄兵[2] 秦新裕[1] 王承培[1] 

机构地区：[1]复旦大学医学院(原上海医科大学)附属中山医院外科,上海200032 [2]复旦大学公共卫生学院劳动卫生教研室,上海200032

出　　处：《中国普外基础与临床杂志》2002年第3期145-147,共3页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的　探讨胃癌的生物学特性及与临床之间的关系。方法　对 10 3 4例各期、各个部位的胃癌的临床及病理资料进行回顾性分析。结果　早期胃癌 14 8例 ,占总数的 14 .3 % ;胃体和胃底部的胃癌淋巴结转移率明显高于其它部位的胃癌 (P<0 .0 0 0 1) ;肿瘤直径大的胃癌分化差 (P=0 .0 0 4)、浸润深 (P<0 .0 0 0 1) ,淋巴结转移率也较高 (P<0 .0 1)。浸润深度较深的胃癌患者平均年龄大于浸润深度较浅的患者 (P=0 .0 0 3 ) ,分化差的患者平均年龄低于分化好的患者 (P<0 .0 0 0 1)。女性患者的肿瘤相当一部分位于胃的近端 ,男性则以位于胃的远端为多见 (P<0 .0 0 1) ;女性患者肿瘤分化差的比例高于男性 (P<0 .0 0 1) ,淋巴结转移率 >3 0 %以上者也比男性高 (P=0 .0 1)。多因素线性多元回归分析发现 ,肿瘤部位 (P=0 .0 0 3 )、直径 (P<0 .0 0 0 1)、浸润深度 (P<0 .0 0 0 1)及分化程度 (P<0 .0 0 1)与淋巴结转移密切相关 ,女性患者较男性更易发生淋巴结转移 (P<0 .0 0 1) ,其中决定淋巴结转移最重要的因素是肿瘤浸润胃壁的深度。全胃切除术清扫的淋巴结数最多 ,其次为远端胃大部切除术 ;术后并发症发生率最高的手术是经腹近端胃大部切除术 (17% )。结论　为降低术后复发 。Objective To study and analyse the correlation between biologic behavior and clinical factors in gastric cancer.Methods Clinical and pathological study of carcinoma of stomach were retrospectively made in 1 034 patients. Results In this series,148 of 1 034 patients (14.3%) were early gastric cancer.The frequency of lymph nodes metastasis was higher in proximal gastric cancer than distal ( P <0.0001).Similar frequency can also be seen in the tumor of larger diameter ( P <0.01),deeper invasion ( P <0.0001) and poor differentiation ( P =0.004).Some difference in ages and sex of patients may be found on the invasion ( P =0.003),differentiation ( P <0.0001),site ( P <0.001) and frequency of lymph nodes metastasis of the tumor ( P =0.01).In multifactorial multivariate linear regression analysis,the site of tumor ( P =0.003),diameter of tumor ( P <0.0001),depth of tumor infiltration ( P <0.0001) and the cell differentiation showed significant association with lymph node metastasis,in which the female patient had more lymph node metastasis than male ( P <0.001).Depth of tumor infiltration was the most important factor in lymph node metastasis.Numbers of lymph nodes resected were much more in total and distal gastrectomies than that in proximal gastrectomy ( P <0.0001). Conclusion The results of this study suggest that radical gastrectomy with lymphadenectomy is necessary even in all stages of gastric cancer.

关 键 词：胃癌 胃大部切除术 根治术 肿瘤转移 病理学 

分 类 号：R735.2[医药卫生—肿瘤]