胃癌肝转移患者的临床特征及相关危险因素分析  

Analysis of clinical features and related risk factors of patients with liver metastases of gastriccancer

作　　者：王培培 韩敏[1] 吴志军[1] WANG Peipei;HAN Min;WU Zhijun(Department of Cancer Radiology,Maanshan People's Hospital,Maanshan 243000,China)

机构地区：[1]马鞍山市人民医院肿瘤放射科,安徽马鞍山243000

出　　处：《中国肿瘤外科杂志》2022年第6期587-590,共4页Chinese Journal of Surgical Oncology

基　　金：安徽省重点研究与开发计划项目(1804b06020351)。

摘　　要：目的探讨胃癌肝转移患者的临床特征及相关危险因素分析。方法回顾性分析马鞍山市人民医院2017年1月至2021年12月收治的胃癌患者256例。经术前CT检查、术后病理活检证实胃癌肝转移患者98例,胃癌无肝转移患者158例。通过单因素和多因素分析,探索胃癌肝转移患者相关危险因素。结果单因素分析结果显示,病灶直径大小(χ^(2)=59.552,P<0.001)、分化程度(χ^(2)=56.215,P<0.001)、TNM分期(χ^(2)=47.744,P<0.001)、浸润深度(χ^(2)=46.806,P<0.001)、有无脉管癌栓(χ^(2)=10.022,P=0.002)、有无淋巴结转移(χ^(2)=46.640,P<0.001)、血清CEA水平(χ^(2)=55.163,P<0.001)、血清AFP水平(χ^(2)=40.760,P<0.001)与胃癌发生肝转移相关。性别、年龄、原发病灶部位、组织学类型与胃癌肝转移无关(P>0.05)。二元Logistc回归分析结果显示,病灶直径大小(P=0.037)、分化程度(P=0.013)、TNM分期(P=0.027)、有无脉管癌栓(P<0.001)、有无淋巴结转移(P=0.046)、血清CEA水平(P=0.039)是胃癌肝转移的独立危险因素。结论对于合并肝转移的独立危险因素的胃癌患者进行有针对的排查,可提高胃癌肝转移诊断的准确率。Objective To investigate the clinical characteristics and related risk factors of patients with liver metastasis of gastric cancer.Methods The clinical data of 256 gastric cancer patients admitted to Maanshan People s Hospital from Jan.2017 to Dec.2021 were analyzed retrospectively.Preoperative CT examination and postoperative pathological biopsy were used to confirm 98 cases of gastric cancer with liver metastasis,and 158 cases without liver metastasis.The relevant risk factors for patients with gastric cancer and liver metastasis were analyzed.Results Univariate analysis showed that lesion diameter(χ^(2)=59.552,P<0.001),degree of differentiation(χ^(2)=56.215,P<0.001),TNM stage(χ^(2)=47.744,P<0.001),infiltration depth(χ^(2)=46.806,P<0.001),vascular tumor thrombus(χ^(2)=10.022,P=0.002),lymph node metastasis(χ^(2)=46.640,P<0.001),serum CEA level(χ^(2)=55.163,P<0.001),serum AFP level(χ^(2)=40.760,P<0.001)were correlated with liver metastasis of gastric cancer.Gender,age,primary lesion location,histological type were not correlated with liver metastasis of gastric cancer(P>0.05).The logistc multivariate regression analysis showed that Lesion diameter(P=0.037),degree of differentiation(P=0.013),TNM stage(P=0.027),vascular tumor thrombus(P<0.001),lymph node metastasis(P=0.046),and serum CEA level(P=0.039)were independent risk factors for liver metastasis of gastric cancer.Conclusions Targeted screening for gastric cancer patients with independent risk factors of liver metastasis improves the accuracy of diagnosis of liver metastasis of gastric cancer,make early diagnosis,prolong the survival time of patients and improve the survival rate of patients.

关 键 词：胃癌 肝转移 单因素分析 多因素分析 

分 类 号：R735.2[医药卫生—肿瘤]