摘要
目的：探讨胃癌腹膜转移的危险因素及其预后。方法：回顾性分析352例胃癌患者的临床病理资料进行。结果：全组腹膜转移的发生率为15．1％（53／352）。单因素分析显示，胃癌腹膜转移与性别、组织学类型、浸润深度、淋巴结转移、TNM分期、手术方式及局部复发等有关（均P〈0．01）；多因素分析显示，胃癌腹膜转移独立危险因素是胃壁浸润深度（P=0．016，95％CI=0．570。0．945），TNM分期（P〈O．001，95％CI=2．414～4．027），淋巴结转移（P=0．027，95％CI=1．041．1．964），手术方式（P〈0．001，95％CI=1．203—1．870），局部复发（P〈0．001，95％CI=1．376～2．871）；腹膜转移患者1，2年生存率分别为44％和10％，而无转移患者分别为97．0％和74．0％，两组间生存率差异有统计学意义（x^2=249．411，P〈0．001）。结论：胃癌伴腹膜转移预示肿瘤的恶性程度高，预后较差；而胃壁浸润深度，TNM分期，淋巴结转移，手术方式及局部复发等因素是影响胃癌腹膜种植转移的独立危险因素。
Objective： To investigate the risk factors and prognosis for peritoneal metastasis in gastric cancer. Methods： The clinicopathologic data of 352 patients with gastric cancer were retrospectively analyzed. Results： The peritoneal metastasis rate of the entire group was 15.1% （53/352）. Univariate analysis showed that gastric cancer peritoneal metastasis was related to the sex, histological types, depth of stomach wall invasion, lymph node metastasis, TNM stage, surgical procedure and local recurrence （all P〈0.01）. Multivariate analysis revealed that the depth of gastric wall invasion （P=0.016, 95%CI=0.570-0.945）, TNM stage （P〈0.001, 95%CI=2.414-4.027）, lymph node metastasis （P=0.027, 95%CI=1.041-1.964）, surgical procedure （P〈0.001, 95%CI= 1.203-1.870） and local recurrence （P〈0.001, 95% CI= 1.376-2.871 ） were risk factors for gastric cancer peritoneal metastases. The 1- and 2-year survival rates in patients with peritoneal metastasis were 44% and 10%, which in patients without peritoneal metastasis were 97.0% and 74.0% respectively, and the difference between the survival rates of the two groups had statistical significance （X2=249.411, P〈0.001）.Conclusion： Gastric cancer with peritoneal metastasis predicts the high malignancy and poor diagnosis of the tumor. ＂Ihe depth of gastric wall invasion, TNM stage, lymph node metastasis, surgical procedure and local recurrence are independent significant risk factors for gastric cancer peritoneal metastasis.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2012年第10期1191-1195,共5页
China Journal of General Surgery
关键词
胃肿瘤
肿瘤种植
危险因素
预后
Stomach Neoplasms
Neoplasm Seeding
Risk Factors
Prognosis
