恶性肿瘤家族史与胃癌患者临床病理特征及预后的相关性研究  

Correlation between family history of malignant tumor and clinicopathological characteristics and prognosis of patients with gastric cancer

作　　者：丁平安 胡奕炀 杨沛刚[1] 王晓燕[1] 孟宁[1] 田园[1] 张志栋[1] 王冬[1] 郭洪海[1] 刘洋[1] 李勇[1] 赵群[1] Ding Pingan;Hu Yiyang;Yang Peigang;Wang Xiaoyan;Meng Ning;Tian Yuan;Zhang Zhidong;Wang Dong;Guo Honghai;Liu Yang;Li Yong;Zhao Qun(The Third Department of Surgery,the 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：《国际遗传学杂志》2021年第6期393-400,共8页International Journal of Genetics

基　　金：河北省高等学校科学技术研究项目(ZD2019139);河北卫健委县级公立医院适宜卫生技术推广入库项目(2019024);政府资助临床医学优秀人才培养项目(2019012)。

摘　　要：目的探讨恶性肿瘤家族史(familial history of malignant neoplasm, MN-FH)与胃癌患者临床病理特征及预后之间的关系。方法回顾性分析河北医科大学第四医院外三科自2012年1月1日至2015年1月1日行根治性手术治疗的2386例胃癌患者, 筛选出MN-FH阳性[MN-FH(+)]的患者, 分析临床特征及影响预后的因素。结果 2386例胃癌患者中MN-FH(+)者656例(27.49%), 其中有胃癌家族史193例(29.42%), 其他恶性肿瘤家族史463例(70.58%)。与MN-FH阴性[MN-FH(-)]患者相比, MN-FH(+)胃癌患者的发病年龄更趋于年轻化(P=0.005)。2386例胃癌患者中共有2273例(95.26%)获得完整随访资料, 全组患者5年总生存率(overall survival, OS)为49.32%, 5年无病生存率(disease-free survival, DFS)为44.61%。其中MN-FH(+)患者5年OS为45.29%, 5年DFS为39.67%, 而MN-FH(-)患者5年OS、DFS分别为50.78%、46.40%, 两组患者的5年OS、DFS差异均具有统计学意义(P均<0.05)。单因素分析显示, 患者年龄、肿瘤直径、组织学类型、Borrmann分型、肿瘤浸润深度pT分期、淋巴结转移pN分期、肿瘤pTNM分期、Lauren分型、脉管瘤栓有无、Ki67阳性比例是影响MN-FH(+)胃癌患者预后的危险因素(P均<0.05);COX多因素分析发现, 肿瘤组织学类型(P=0.002)、浸润深度pT分期(P=0.013)、肿瘤pTNM分期(P=0.001)及脉管瘤栓有无(P=0.011)是影响其预后的独立危险因素。结论 MN-FH(+)胃癌具有发病年龄趋于年轻化的特点, 且预后与临床多种病理因素密切相关。Objective To investigate the relationship between the family history of malignant neoplasm(MN-FH)and the clinicopathological characteristics and prognosis of patients with gastric cancer.Methods A retrospective analysis of 2386 patients with gastric cancer who underwent radical surgery from January 1,2012 to January 1,2015 in the Third Department of Surgery of the Fourth Hospital of Hebei Medical University,and MN-FH positive[MN-FH(+)]patients were selected.Analyze clinical characteristics and factors affecting prognosis.Results Among the 2386 cases of gastric cancer,656 cases(27.49%)were MN-FH(+),of which 193 cases(29.42%)had family history of gastric cancer,and 463 cases(70.58%)had family history of other malignant tumors.Compared with MN-FH negative[MN-FH(-)]patients,the age of onset of MN-FH(+)gastric cancer patients tends to be younger(P=0.005).A total of 2273 cases(95.26%)of 2386 patients with gastric cancer received complete follow-up data.The 5-year overall survival(OS)rateof the whole group was 49.32%,and the 5-year disease-free survival(DFS)rate was 44.61%.The 5-year OS of MN-FH(+)patients was 45.29%,the 5-year DFS was 39.67%,while the 5-year OS and DFS of MN-FH(-)were 50.78%and 46.40%,respectively.The 5-year OS of the two groups of patients The differences in DFS and DFS were statistically significant(P<0.05 respectively).Univariate analysis showed that patient’s age,tumor diameter,histological type,Borrmann classification,tumor invasion depth pT staging,lymph node metastasis pN staging,tumor pTNM staging,Lauren classification,vascular tumor thrombus or not,Ki67 positive ratio are the influence MN-FH(+)risk factors for the prognosis of patients with gastric cancer(P<0.05 respectively);COX multivariate analysis found that tumor histological type(P=0.002),depth of invasion pT stage(P=0.013),tumor pTNM stage(P=0.001)and the presence or absence of vascular tumor thrombus(P=0.011)are independent risk factors affecting the prognosis.Conclusion MN-FH(+)gastric cancer has the characteristic that the age of o

关 键 词：胃肿瘤 家族史 临床病理特征 预后 危险因素 

分 类 号：R735.2[医药卫生—肿瘤]