残胃癌和原发性胃癌临床病理特点与生存状况的比较  

Comparison of clinicopathological features and survival status between patients with residual and primary gastric cancer

作　　者：朱晓宇 朱飞 徐朝晖 赵亮亮 Xiao-Yu Zhu;Fei Zhu;Zhao-Hui Xu;Liang-Liang Zhao(Yueqing People’s Hospital,Yueqing 325600,Zhejiang Province,China;Department of GeneralSurgery,Chuzhou Traditional Chinese Medicine Hospital,Zhangzhou 324000,Zhejiang Province,China)

机构地区：[1]乐清市人民医院普外科,浙江省乐清市325600 [2]衢州市中医医院普外科,浙江省衢州市324000

出　　处：《世界华人消化杂志》2019年第10期618-623,共6页World Chinese Journal of Digestology

摘　　要：背景原发性胃癌(gastric cancer, GC)在全球范围内发病率较高,死亡率更是在恶性肿瘤中位居第3位,原发性GC术后和良性疾病远端胃切除术残GC的发病机制是具有差异的,我们认为残GC与原发性GC患者肿瘤远处转移、肿瘤病理分型、局部器官浸润、预后营养指数(prognostic nutrition index, PNI)临床病理特点存在差异,且TNM分期、血清血红蛋白(hemoglobin,Hb)是影响残GC患者术后5年期生存状况的独立危险因素.目的探索残GC和原发性GC临床病理特点与生存状况.方法回顾性分析2012-09/2018-09于乐清市人民医院与衢州市中医院两所医院接受治疗的106例残GC患者的临床资料并作为观察组,并选取同期108例原发性GC作为对照组.分别于患者入院后第2 d或者第3 d收集两组患者临床资料并对比异同.分析影响残GC生存状况的单因素,有统计学意义的相关因素行多因素Logistic回归分析.结果观察组肿瘤远处转移M0占比明显高于对照组组肿瘤远处转移M0占比,观察组肿瘤病理分型分化不良型占比、有局部器官浸润占比、PNI>45%占比、Hb指标水平显著低于对照组,数据对比具有统计学意义(P <0.05);两组患者TNM分期、血清白蛋白、住院天数对比不具有统计学意义(P >0.05).单因素分析结果显示,手术类型、TNM分期、肿瘤远处转移、Hb、血清白蛋白是影响残GC患者术后生存状况的相关因素(P <0.05),数据对比具有统计学意义(P <0.05).多因素分析结果显示, TNM分期、Hb是影响残GC患者术后5年期生存状况的独立危险因素(OR = 1.442、3.012, P = 0.004、0.018).结论残GC与原发性GC患者肿瘤远处转移、肿瘤病理分型、局部器官浸润、PNI临床病理特点存在差异,且TNM分期、Hb是影响残GC患者术后5年期生存状况的独立危险因素.BACKGROUND The incidence of primary gastric cancer (GC) is high in the world, and its mortality rate ranks third among all malignant tumors. The pathogenesis of residual GC in patients with primary GC and benign disease is different. We believe that distant metastasis, tumor pathological type, local organ infiltration, clinicopathological features, and prognostic nutrition index (PNI) differ between patients with residual and primary GC, and TNM stage and hemoglobin (Hb) are the independent risk factors for five-year survival of patients with residual GC. AIM To explore the clinicopathological features and survival status of patients with residual and primary GC. METHODS The clinical data of 106 patients with residual GC who were treated at our hospital from September 2012 to September 2018 were retrospectively analyzed and included in an observation group, while 108 primary GC cases were selected as a control group. Clinicopathological data of the two groups were collected and compared. Factors affecting the survival of patients with residual GC were evaluated by univariate analysis, and statistically significant factors in univariate analysis were further analyzed by multivariate logistic regression analysis. RESULTS The proportion of patients with M0 stage was significantly higher in the observation group than in the control group (P < 0.05). The proportions of patients with poor tumor pathological differentiation, local organ infiltration, PNI > 45%, and low Hb levels were significantly lower than those of the control group (P < 0.05). There was no statistically significant difference in TNM stage, serum albumin, or hospitalization days between the two groups (P > 0.05). Univariate analysis showed that type of surgery, TNM stage, distant metastasis, Hb, and serum albumin were the factors significantly affecting the postoperative survival of patients with residual GC (P < 0.05). Multivariate analysis showed that TNM stage and Hb were independent risk factors for the 5-year survival of patients with residual GC

关 键 词：残胃癌 原发性胃癌 临床病理特点 生存状况 

分 类 号：R735.2[医药卫生—肿瘤]