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[淋巴结阴性转移胃腺癌患者的临床病理特征及其生存分析]

[Clinicopathologic features of the patients with node-negative metastasis gastric adenocarcinoma and their survival analysis].

作者信息

Li Jian, Cai Shi-rong, He Yu-long, Huang Mei-jin, Mei Kai-yong, Wang Jian-ping, Zhan Wen-hua

机构信息

Department of Gastrointestinopancreatic Surgery, The First Affiliated Hospital, Sun Yet-sen University, Guangzhou 510080, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2006 May;9(3):230-3.

Abstract

OBJECTIVE

To investigate the clinicopathologic features of the patients with node-negative metastasis (pN0) gastric carcinoma confirmed by routine pathologic examination (Ha&E staining),and their relationship with survival.

METHODS

The clinico-pathologic data of 87 pN0 gastric carcinoma patients were analyzed retrospectively. Kaplan-Meier (Log-rank) method was used to compare the survival rate,and Cox regression method was used to screen the independent prognosis factors for pN0 gastric cancer.

RESULTS

There were 69 males and 18 females. D(2) lymphadenectomy was performed in 75 (86.2%), and D(3) in 13 cases (13.8%). Distal gastrectomy was performed in 59 (67.8%), total gastrectomy in 24 (27.6%) and proximal gastrectomy in l4 cases (4.6%). Twenty-three (26.4%) cases received postoperative chemotherapy and 64 (73.6% ) did not. The 5-year survival rate of the 87 pN0 gastric carcinoma patients was 56.5%. There were no differences in survival rate considering age, tumor location, gastrectomy, lymph nodes dissection, differentiation grade, and tumor-stroma relationship (P > 0.05), while the differences were significant in survival rate between the patients with postoperative chemotherapy,lymphatic invasion,venous invasion or not,and different pT staging (all Pa< 0.05). The Cox regression analysis revealed that pT staging and postoperative chemotherapy were independent prognostic factors.

CONCLUSION

pT staging and postoperative chemotherapy are independent prognostic factors. It is necessary to develop a precise staging technique to select a suitable surgical therapy or confirm which patients should accept postoperative chemotherapy in pN0 gastric carcinoma patients.

摘要

目的

探讨经常规病理检查(苏木精-伊红染色)确诊的淋巴结阴性转移(pN0)胃癌患者的临床病理特征及其与生存的关系。

方法

回顾性分析87例pN0胃癌患者的临床病理资料。采用Kaplan-Meier(对数秩检验)法比较生存率,采用Cox回归法筛选pN0胃癌的独立预后因素。

结果

男性69例,女性18例。75例(86.2%)行D(2)淋巴结清扫术,13例(13.8%)行D(3)淋巴结清扫术。59例(67.8%)行远端胃切除术,24例(27.6%)行全胃切除术,14例(4.6%)行近端胃切除术。23例(26.4%)患者接受术后化疗,64例(73.6%)未接受。87例pN0胃癌患者的5年生存率为56.5%。年龄、肿瘤部位、胃切除术、淋巴结清扫、分化程度和肿瘤-间质关系对生存率无差异(P>0.05),而术后化疗、有无淋巴管侵犯、静脉侵犯及不同pT分期患者的生存率差异有统计学意义(均P<0.05)。Cox回归分析显示pT分期和术后化疗是独立的预后因素。

结论

pT分期和术后化疗是独立的预后因素。有必要开发精确的分期技术,以选择合适的手术治疗方法或确定哪些pN0胃癌患者应接受术后化疗。

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