行胃癌腹腔镜辅助保留幽门胃切除术Ⅰa~Ⅱa期患者预后的影响因素分析  

Analysis of prognostic factors in patients with stage Ia-IIa gastric cancer undergoing laparoscopy-assisted pylorus preserving gastrectomy

作　　者：计军涛 王静英 JI Juntao;WANG Jingying(Department of General Surgery,Xuchang Hospital,Xuchang 461000,He’nan,China)

机构地区：[1]许昌医院普通外科,河南许昌461000

出　　处：《癌症进展》2025年第5期599-602,共4页Oncology Progress

摘　　要：目的分析行腹腔镜辅助保留幽门胃切除术(LAPPG)Ⅰa~Ⅱa期胃癌患者预后的影响因素。方法选取75例Ⅰa~Ⅱa期胃癌患者,均接受LAPPG治疗,随访1年,记录患者的预后情况,胃癌LAPPG患者预后的影响因素采用多因素Logistic回归分析。结果75例胃癌LAPPG患者手术时间(232.26±25.16)min,淋巴结清扫数目(19.75±3.60)枚,术中出血量(101.45±10.87)ml,首次排便时间(4.93±1.25)天,首次排气时间(4.06±0.87)天,并发症总发生率为6.67%(5/75)。随访1年发现,75例胃癌LAPPG患者,预后不良21例,占28.00%(21/75)。Logistic回归分析结果显示,肿瘤直径大、分化程度低及血清胃泌素-17(GAS-17)、癌胚抗原(CEA)、糖类抗原72-4(CA72-4)水平升高均是胃癌LAPPG患者预后不良的独立危险因素(P﹤0.05),体重指数(BMI)高是胃癌LAPPG患者预后良好的独立保护因素(P﹤0.05)。结论Ⅰa~Ⅱa期胃癌患者接受LAPPG的效果较为满意,BMI、肿瘤直径、分化程度及血清GAS-17、CEA、CA72-4水平可能与患者的预后有关。Objective To analysis the prognostic factors in patients with stage Ia~IIa gastric cancer undergoing laparoscopy-assisted pylorus preserving gastrectomy(LAPPG).Method A total of 75 patients with stage Ia-IIa gastric cancer were selected and underwent LAPPG treatment.They were followed up for 1 year and their prognosis was recorded.Multivariate Logistic regression analysis was used to analysis the prognostic influencing factors of patients with gastric cancer undergoing LAPPG.Result The surgical time in 75 patients with gastric cancer undergoing LAPPG was(232.26±25.16)min,lymph node dissections was(19.75±3.60),intraoperative blood loss was(101.45±10.87)ml,first bowel movement time was(4.93±1.25)days,and first exhaust time was(4.06±0.87)days,the total incidence of complications was 6.67%(5/75).During 1 year follow-up,among 75 patients with gastric cancer undergoing LAPPG,21 cases had poor prognosis,accounting for 28.00%(21/75).Multivariate Logistic regression analysis showed that large tumor diameter,low differentiation degree,and elevated levels of serum gastrin-17(GAS-17),carcinoembryonic antigen(CEA),and carbohydrate antigen 72-4(CA72-4)were independent risk factors for poor prognosis in patients with gastric cancer undergoing LAPPG(P<0.05),while high body mass index(BMI)was independent protective factor for good prognosis in patients with gastric cancer undergoing LAPPG(P<0.05).Conclusion The effect of LAPPG on stage Ia-IIa gastric cancer patients is relatively satisfactory,BMI,tumor diameter,differentiation degree,and serum levels of GAS-17,CEA,and CA72-4 may be related to the prognosis of patients.

关 键 词：胃癌 腹腔镜辅助保留幽门胃切除术 预后 影响因素 

分 类 号：R735.2[医药卫生—肿瘤]