进展期胃癌新辅助治疗后发生疾病进展患者的临床病理特征及预后分析  

Clinicopathologic parameters and prognostic analysis of progressive disease after neoadjuvant therapy for locally advanced gastric cancer

作　　者：田园[1] 杨沛刚[1] 李勇[1] 范立侨[1] 张志栋[1] 王冬[1] 赵雪峰[1] 檀碧波[1] 赵群[1] Tian Yuan;Yang Peigang;Li Yong;Fan Liqiao;Zhang Zhidong;Wang Dong;Zhao Xuefeng;Tan Bibo;Zhao Qun(The 3rd Department of Surgery,Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院外三科,石家庄050011

出　　处：《中华普通外科杂志》2021年第4期249-253,共5页Chinese Journal of General Surgery

基　　金：政府资助临床医学优秀人才培养项目(201912);河北省医学科学研究重点课题计划项目(20201137);河北卫健委县级公立医院适宜卫生技术推广入库项目(2019024)。

摘　　要：目的探讨进展期胃癌新辅助治疗后发生疾病进展(PD)患者的临床病理特征及预后。方法回顾性分析2011年6月至2016年3月河北医科大学第四医院收治的569例局部进展期胃癌患者(cT3/4N0/+M0)接受新辅助治疗及手术治疗的临床资料,分析发生PD的临床相关因素及预后。结果本组569例患者全部完成新辅助治疗并进行疗效评价,其中59例(10.4%)患者发生PD。单因素分析结果显示,肿瘤大小(χ^(2)=10.091,P=0.001)、病理类型(χ^(2)=4.110,P=0.043)、Borrmann分型(χ^(2)=91.941,P=0.001)及治疗前cT分期(χ^(2)=7.980,P=0.005)均与新辅助治疗后发生PD有关;多因素回归分析结果显示,病理类型、Borrmann分型、治疗前cT分期是影响进展期胃癌新辅助治疗后发生PD的独立危险因素。发生PD后患者的总生存期和无疾病进展生存期较未发生PD患者的缩短,发生局部PD的患者选择二线治疗或手术切除对生存影响并无差异。结论病理类型、Borrmann分型、治疗前cT分期是进展期胃癌患者在新辅助治疗后发生PD的影响因素;PD患者的预后差。Objective To investigate the clinically relevant factors of progressive disease(PD)after neoadjuvant therapy for locally advanced gastric cancer.Methods From Jun 2011 to Mar 2016,569 patients with locally advanced gastric cancer(cT3/4N0/+M0)admitted to the Fourth Hospital of Hebei Medical University were retrospectively analyzed.Results All 569 patients completed neoadjuvant therapy,59 patients(10.4%)had PD.Univariate analysis showed that tumor size(χ^(2)=10.091,P=0.001),pathological type(χ^(2)=4.110,P=0.043),Borrmann type(χ^(2)=91.941,P=0.001),pre-treatment cT stage(χ^(2)=7.980,P=0.005)were associated with PD after neoadjuvant therapy for gastric cancer.The results of multi-factor regression analysis showed that pathological type,Borrmann type,pre-treatment cT stage were independent factors influencing the occurrence of PD after neoadjuvant therapy for advanced gastric cancer.The overall survival and progression-free suruival time of patients with PD is significantly shorter than that of patients without PD.Conclusion The pathological type,Borrmann typing and pre-treatment cT stage are the influencing factors for the occurrence of PD after neoadjuvant treatment in advanced gastric cancer,and the prognosis of PD patients is poor.

关 键 词：胃肿瘤 肿瘤辅助治疗 病理学 临床 预后 

分 类 号：R735.2[医药卫生—肿瘤]