不同部位胃癌患者根治术的临床病理分析及预后比较  

Comparison of clinicopathological features and prognosis of radical gastrectomy for gastric cancer at different sites

作　　者：袁政[1] 唐伟[1] 沈韧斌[1] 顾新华[1] 

机构地区：[1]江苏省苏州市立医院本部普外科,215002

出　　处：《临床外科杂志》2014年第10期726-728,共3页Journal of Clinical Surgery

摘　　要：目的：探讨不同部位胃癌患者根治术的临床病理特点及其对预后的影响。方法回顾性分析行胃癌根治术的胃癌患者168例的临床资料，将患者根据肿瘤部位分为胃上部癌（42例）、胃中部癌（57例）、胃下部癌（69例）三组，并对其临床病理特点、预后进行比较。结果胃上部癌男性患者比例较高（78．6％），平均年龄亦较中、下部癌高；上部癌、中部癌、下部癌中肿瘤直径≥4 cm的分别占71．4％、49．1％、29．0％（P＜0．05）；上部癌的全胃切除、联合脏器切除的比例显著高于中部、下部癌（P＜0．05）；术后3年，上部癌的生存率明显低于中部癌和下部癌（P＜0．05）；多因素Logistic回归分析显示，淋巴结转移、TNM分期高、上部癌均是胃癌术后生存的独立危险因素（均P＜0．05）。结论胃上部癌与中、下部癌临床病理特征明显不同，且其预后较差，结合肿瘤生长部位并据此选择合理的术式有助于改善患者预后，提高生存率。Objective To explore the clinicopathological features of radical gastrectomy for gastric cancer at different sites and analyze its impact on prognosis.Methods The clinical data of 168 casesof gastric carcinoma were restrospectively reviewed.According to the lesion sites,patients were divided into3 groups：the upper portion group（42 cases）,middle portion group（57 cases）and lower portion group（69cases）.Their clinicopathological features and prognosis were compared.Results In the upper portiongroup,the percentage of male patient was relatively greater and their average age was higher than the othergroups.The porpotions of large tumor size（diameter 〉4 cm）were 71.4%,49.1% and 29.0% in the upper,middle and lower portion group,respectively（P 〈0.05）.The ratio of total gastrectomy and combinedmultiple organs resection in was higher than the other groups（P 〈0.05）.At the 3rd year after surgery,thesurvival rate in the upper portion group was significantly lower than the other groups（P 〈0.05）.Multiplelogistic regression analysis revealed that lymphatic metastasis,TNM stage,upper portion were the independent risk factors of postoperative survival of gastric cancer（P 〈0.05）.Conclusion The clinicopathological features of the upper gastric cancer are quite different from the middle and lower cancer,and itsprognosis is poorer.According to the lesion sites,selecting reasonable surgical procedures is contribute toimprove the prognosis and survival rate.

关 键 词：胃癌 部位 病理特征 预后 

分 类 号：R735.2[医药卫生—肿瘤]