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妊娠合并胃癌的临床特征

Clinical characteristics of gastric cancer associated with pregnancy.

作者信息

Lee Hyuk-Joon, Lee In Kyu, Kim Jong Won, Lee Kuhn Uk, Choe Kuk Jin, Yang Han-Kwang

机构信息

Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.

出版信息

Dig Surg. 2009;26(1):31-6. doi: 10.1159/000193330. Epub 2009 Jan 20.

Abstract

BACKGROUND/AIMS: This study was conducted to evaluate the clinical features and treatment outcome of gastric cancer associated with pregnancy.

METHODS

Clinicopathologic characteristics of 15 patients who were diagnosed as having gastric cancer during pregnancy or within 1 year after delivery (the P-related group) were compared with those of 53 age-matched pregnancy-unrelated gastric cancer patients (the control group).

RESULTS

Significant differences were found in tumor stage and surgical curability; the numbers of stage IV disease were 12 (80%) and 21 (40%; p = 0.006), and those of curative resection were 4 (27%) and 20 (62%; p = 0.02) in the P-related and the control group, respectively. Three-year survival rate was significantly lower in the P-related group (23.3%) than in the control group (52.8%; p = 0.007). In the P-related group, only 3 patients, including one patient diagnosed using endoscopy, survived without recurrences. In the multivariate analysis, pregnancy was not identified as an independent risk factor associated with poor outcome.

CONCLUSION

Gastric cancer associated with pregnancy is discovered at its advanced stage and consequently shows a dismal prognosis. Considering that the patients who underwent curative resection have a favorable prognosis, primary efforts should be focused on early diagnosis.

摘要

背景/目的:本研究旨在评估妊娠合并胃癌的临床特征及治疗效果。

方法

将15例在孕期或产后1年内被诊断为胃癌的患者(妊娠相关组)的临床病理特征与53例年龄匹配的非妊娠相关胃癌患者(对照组)进行比较。

结果

在肿瘤分期和手术可切除性方面发现了显著差异;妊娠相关组和对照组中IV期疾病的数量分别为12例(80%)和21例(40%;p = 0.006),根治性切除的数量分别为4例(27%)和20例(62%;p = 0.02)。妊娠相关组的三年生存率(23.3%)显著低于对照组(52.8%;p = 0.007)。在妊娠相关组中,只有3例患者存活且无复发,其中1例通过内镜检查确诊。在多因素分析中,妊娠未被确定为与不良预后相关的独立危险因素。

结论

妊娠合并胃癌多在晚期被发现,因此预后较差。鉴于接受根治性切除的患者预后良好,应将主要精力集中在早期诊断上。

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