胃肠道癌术后种植转移的临床特征及预后分析  

Clinical Features and Prognosis of Implantation Metastasis Carcinoma in Postoperative Gastrointestinal Cancer

作　　者：罗云[1,2] 王崇树[1] 蒋汉刚 吕其君[1] 徐秀连[1] 

机构地区：[1]川北医学院附属医院,四川南充637000 [2]川北医学院肝胆胰肠研究所,四川南充637000 [3]川北医学院临床医学系,四川南充637000

出　　处：《肿瘤学杂志》2016年第10期783-788,共6页Journal of Chinese Oncology

基　　金：四川省卫生厅科研资助项目(120430)

摘　　要：[目的]探讨胃肠道癌术后种植转移的临床特征及预后。[方法]回顾性分析52例胃肠道癌并术后种植转移患者的临床资料和随访结果。[结果]在种植转移的原发胃肠道癌中,98.1%(51/52)病例为T4期,82.7%(43/52)为低分化腺癌,腹水量≥100ml占73.1%(38/52),术后常规化疗者占75%(39/52),术后常规化疗组与未化疗组的种植转移时间差异无统计学意义(P>0.05),胃肠道癌术后种植转移1、3、5年总生存率分别为84.0%、54.2%和15.8%;单因素生存分析显示,原发癌的TNM分期、腹水量、远处器官转移是影响患者预后生存的主要因素(P<0.05),而多因素分析显示远处器官转移是预后最为明显的危险因素(P<0.05)。[结论]种植转移的原发胃肠道癌的恶性程度高、分期晚、分化低,常规化疗不能有效预防种植转移癌,原发癌的TNM分期、术中腹水量、远处器官转移是种植转移主要的不良预后因素,其中远处器官转移是最为明显的危险因素。[Objective] To investigate the clinical characteristics and prognosis of implantation metastasis carcinoma in postoperative gastrointestinal cancer. [Methods] Clinical data and followup results of 52 patients with implantation metastasis carcinoma in postoperative gastrointestinal cancer were retrospectively analyzed. [Results] In the primary gastrointestinal cancers with postoperative implantation metastasis,98.1%（51/52） cases was T4 stage,82.7%（43/52） of the pathological types were poorly differentiated adenocarcinoma,ascites（≥100ml） accounted for 73.1%（38/52）,and the cases for postoperative routine chemotherapy were 75%（39/52）. There was no statistical significance in the planting time of post operation between conventional chemotherapy group and non chemotherapy group（P〉0.05）. The 1,3,5-year overall survival rates in the implantation metastasis carcinomas were 84.0%,54.2% and 15.8% respectively. Univariate survival analysis showed that the TNM stage,ascites and distant organ metastasis were the main factors influencing the prognosis of patients（P〈0.05）,and multivariate analysis revealed that distant organ metastasis was the most significant risk factor for prognosis（P〈0.05）. [Conclusions] The primary gastrointestinal cancers with postoperative implantation metastasis are high degree malignant,low differentiation and advanced stage,conventional chemotherapy after surgery can not effectively prevent implantation metastasis carcinoma,the TNM stage,ascites and distant organ metastasis of primary gastrointestinal cancers with postoperative implantation metastasis are the main factors influencing prognosis,while the distant organ metastasis is the most obvious risk factors.

关 键 词：种植转移瘤 临床特征 预后 

分 类 号：R735.2[医药卫生—肿瘤] R735.3[医药卫生—临床医学]