摘要
目的探讨ypTNM分期系统对新辅助化疗后行D2胃癌根治术患者的预后评估价值。方法回顾性分析新辅助化疗后行D2胃癌根治术的168例患者临床资料。根据分期方法将患者分为ypTNM分期组(n=80)与pTNM分期组(n=88),比较两组患者临床基本资料的差异,应用ROC曲线及Logistic回归分析探究不同分期方法与患者生存情况的关系。结果ypTNM分期组与pTNM分期组患者的年龄、性别、BMI、美国麻醉学会分级(ASA)、手术时间、手术方式、失血量等基本资料差异无统计学意义。两组患者的肿瘤部位、淋巴结清扫数目、病理类型、分化程度、肿瘤直径(长轴)及血管侵犯等临床观察指标差异也均无统计学意义。ypTNM分期对于新辅助化疗后行D2胃癌根治术患者的有预测价值(P<0.001)。ypTNM分期是新辅助化疗后行D2胃癌根治术患者生存情况的独立危险因素(P<0.05)。结论ypTNM分期可以作为新辅助化疗后行D2胃癌根治术患者预后预测的方法。分期≥Ⅲ期提示患者术后预后差。
Objective To evaluate the prognostic value of ypTNM staging system in patients undergoing gastrectomy with D2 lymphadenectomy after neoadjuvant chemotherapy.Methods A retrospective analysis was made of the clinical data of 168 patients who underwent radical gastrectomy for D2 gastric cancer after neoadjuvant chemotherapy.According to the staging method,patients were divided into ypTNM staging group(80)and pTNM staging group(88).The differences of basic clinical data between the 2 groups were compared.ROC curve and Logistic regression analysis were used to explore the relationship between different staging methods and patients'survival.Results There was no significant difference in age,sex,BMI,ASA,operation time,operation mode and blood loss between ypTNM and pTNM stages.There was no significant difference between the 2 groups in tumor location,number of lymph node dissection,pathological type,differentiation degree,tumor diameter(long axis)and vascular invasion.ypTNM staging had predictive value for patients undergoing gastrectomy with D2 lymphadenectomy after neoadjuvant chemotherapy(P<0.001).ypTNM staging was an independent risk factor for survival of patients undergoing after neoadjuvant chemotherapy(P<0.05).Conclusion ypTNM staging can be used as a prognostic method for patients undergoing radical gastrectomy for D2 gastric cancer after neoadjuvant chemotherapy.Stage greater than or equal to stage III indicates poor prognosis.
作者
周博
徐菁
王统杰
ZHOU Bo;XU Jing;WANG Tongjie(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,471000)
出处
《实用癌症杂志》
2021年第10期1669-1672,共4页
The Practical Journal of Cancer
基金
河南省医学科技攻关计划项目(编号:2018020282)。
