Lauren分型在胃癌预后评估中的临床意义  

Clinical significance of Lauren typing in the prognosis evaluation of gastric cancer

作　　者：崔景利 梁寒[1] 邓靖宇[1] 丁学伟[1] 潘源[1] 张李[1] 蔡明志[1] 梁月祥[1] 蒋楠[1] 

机构地区：[1]天津医科大学肿瘤医院胃部肿瘤科,国家肿瘤临床医学研究中心,天津市“肿瘤防治”重点实验室,300060

出　　处：《中华消化杂志》2014年第7期449-452,共4页Chinese Journal of Digestion

基　　金：国家重点研究发展计划973计划（2010CB529301）;天津市科技计划项目（12ZCDZSY16400）

摘　　要：目的 探讨Lauren分型在胃癌预后评估中的临床意义.方法 选取2003年6月至2007年6月无远处转移、接受胃癌根治术治疗、术后病理检查确诊、临床病理和随访资料完整的1 275例胃癌患者为研究对象.根据WHO分型,分为管状腺癌、乳头状腺癌、黏液腺癌和印戒细胞癌.根据Lauren分型,分为肠型和弥漫型.以患者死亡为随访终点,随访截止时间为2012年12月11日.采用Kaplan-Meier法计算各组生存率,采用Log-rank法进行显著性检验,以Cox模型进行生存分析.计量资料行t检验,计数资料行卡方检验.结果 在WHO分型中,780例胃管状腺癌、61例胃乳头状腺癌、216例胃黏液腺癌、218例印戒细胞癌患者的5年总体生存率分别为45.6％、42.7％、29.7％、35.7％,整体间比较差异有统计学意义（χ2=15.753,P＜0.01）. 654例肠型和621例弥漫型胃癌患者的5年总体生存率分别为48.1％和33.7％,差异有统计学意义（χ2=26.723,P＜0.01）.在810例胃癌淋巴结转移者中,404例肠型和406例弥漫型患者的5年总体生存率分别为34.1％和22.7％,差异有统计学意义（χ2=18.872,P＜0.01）.在467例胃癌无淋巴结转移者中,252例肠型和215例弥漫型患者的5年总体生存率分别为69.1％和55.0％,差异有统计学意义（χ2=6.285,P＜0.05）.在792例接受化学疗法治疗的胃癌患者中,394例肠型和398例弥漫型患者的5年总体生存率分别为53.2％和31.1％,差异有统计学意义（χ2=26.844,P＜0.05）.在未接受化学疗法治疗的胃癌患者中,肠型和弥漫型患者的5年总体生存率差异无统计学意义（P＞0.05）.在TNM Ⅰ期的胃癌患者中,肠型和弥漫型患者的5年总体生存率差异无统计学意义（P＞0.05）.在393例TNMⅡ期患者中,212例肠型和181例弥漫型胃癌患者的5年总体生存率分别为64.3％和48.2％,差异有统计学意义（#=6.436,P＜0.05）.在766例TNMⅢ期患者中,377例肠型和389例弥漫型胃癌患者的5年总体�Objective To explore the clinical significance of Lauren typing in the prognosis evaluation of gastric cancer.Methods From June 2003 to June 2007,1 275 patients with gastric cancer were selected as study objects,who received radical gastrectomy,and got the pathological diagnosis after surgery.The clinic-pathological and follow-up data of them were complete.According to World Health Organization （WHO） typing,gastric cancer was divided into tubular adenocarcinoma,papillary adenocarcinoma,mucinous adenocarcinoma and signet ring cell carcinoma.According to Lauren typing,it was divided into intestinal and diffuse type.The death of patient was regarded as the endpoint of the follow-up.The deadline of the follow-up was December 11,2012.The survival rate of each group was calculated by Kaplan-Meier method.The significance was tested with Log-rank method and survival analysis was analyzed with Cox model.Measurement data was analyzed by t test and chi-square test was for count data.Results According to WHO typing,the five year survival rate of 780 tubular adenocarcinoma,61 papillary adenocarcinoma,216 mucinous adenocarcinoma and 218 signet ring cell carcinoma was 45.6%,42.7%,29.7% and 35.7%,respectively.In overall comparison,the difference was statistically significant （χ2 =15.753,P〈0.01）.The five year survival rate of 654 intestinal type and 621 diffuse type gastric cancer was 48.1% and 33.7 %,the difference was statistically significant （χ2 =26.723,P〈0.01）.Among 810 gastric cancer with lymph nodes metastasis,the five year survival rate of 404 intestinal type and 406 diffuse type was 34.1% and 22.7%,the difference was statistically significant （χ2 =18.872,P〈0.01）.Among 467 gastric cancer without lymph nodes metastasis,the five year survival rate of 252 intestinal type and 215 diffuse type was 69.1% and 55.0%,the difference was statistically significant （χ2 =6a.285,P〈0.05）.Among 792 patients with gastric cancer who received chemical therapy,the five year survival rate of 394 intestinal type

关 键 词：胃肿瘤 病理学 临床 预后 

分 类 号：R735.2[医药卫生—肿瘤]