胃腺鳞癌的临床病理特点和生存状况研究  

Clinic pathological features and survival of gastric adenocarcinoma

作　　者：李旸[1] 王自强[1] 罗凤鸣[2] LI Yang;WANG Zi-qiang;LUO Feng-ming(Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu , Sichuan 611730, China)

机构地区：[1]四川大学华西医院胃肠外科,四川成都611730 [2]四川大学华西医院全科医学科,四川成都611730

出　　处：《中国临床研究》2018年第6期738-740,共3页Chinese Journal of Clinical Research

基　　金：国家自然科学基金(81270129)

摘　　要：目的探究胃腺鳞癌的临床病理特点和生存状况。方法选取2007年1月至2012年8月收治的85例胃腺鳞癌患者作为研究对象,收集患者的临床病理特征,对患者进行为期5年的随访,记录患者的生存状况。结果在85例胃腺鳞癌患者中男59例,女26例,年龄(56.5±3.1)岁;Ⅱ期20例(23.53%),Ⅲ期58例(68.24%),Ⅳ期7例(8.24%);肿瘤直径<5 cm 61例(71.76%),>5 cm 24例(28.24%);有淋巴结转移58例(68.24%),无淋巴结转移27例(31.76%);腹痛腹泻是主要临床症状,占65.88%,其次是发热乏力和反酸胀气,占比分别为31.76%和22.35%。单因素分析结果显示肿瘤TNM分期(χ~2=4.157,P=0.042)、肿瘤最大直径(χ~2=4.876,P=0.032)影响患者的预后。多因素分析结果显示肿瘤最大直径>5 cm(OR=2.249,95%CI:1.312~3.243,P=0.004)、肿瘤TNM分期Ⅳ期(OR=3.211,95%CI:1.243~4.322,P=0.016)及有淋巴结转移(OR=3.372,95%CI:1.445~3.981,P=0.032)是影响患者预后的独立危险因素(P<0.05,P<0.01)。结论原发性胃腺鳞癌预后差,应该及时进行手术治疗,肿瘤最大直径、肿瘤TNM分期是患者预后评估的关键。Objective To investigate the clinic pathological features and survival of gastric adenocarcinoma. Methods A total of 85 patients with gastric adenocarcinoma who received treatment from January 2007 to August 2012 were selected, and their clinic pathological features were collected. All the patients were followed up for 5 years to record their survival situation. Results There were 59 males and 26 females in all the 85 patients with gastric adenocareinoma （ age 56. 5 ± 3.1 ）. There were 20 patients （23.53%） in stage Ⅱ ,58 patients （68.24%） in stage Ⅲ and 7 patients （8.24%） in stage IV. There were 58 patients with lymph node metastasis （68.24%） and 27 patients without lymph node metastasis （31.76% ）. Abdominal pain and diarrhea were the main clinical symptoms （65.88 % ）, followed by fever, fatigue and acid regurgitation ,accounting for 31.76% and 22.35% respectively. The resuhs of single factor analysis showed that TNM staging （X2 = 4. 157,P = 0. 042）, the maximum diameter of tumor （X2 = 4. 876, P = 0. 032 ） affected the prognosis of the patients. The results of multifactor analysis showed that the tumor＇s maximum diameter 〉 5 cm （ OR = 2.249,95% CI： 1.312-3.243,P =0.004）,TNM staging 1V （OR =3.211,95% CI：1.243 -4.322,P =0.016） and lymph node metastasis （OR = 3. 372,95% CI： 1. 445 -3. 981, P = 0. 032） were independent risk factors affecting the prognosis of the patients. Conclusion The primary gastric adenoeareinoma has a bad prognosis. Surgical treatment should be performed in time. The maximum diameter of tumor and TNM staging are the key to the prognosis of primary gastric adenoeareinoma.

关 键 词：胃腺鳞癌 临床病理 生存状况 预后 肿瘤最大直径 TNM分期 

分 类 号：R735.2[医药卫生—肿瘤]