Cai Shi-Rong, Chen Chuang-Qi, Ma Jin-Ping, Chen Jian-Hui, Song Wu, He Yu-Long, Zhan Wen-Hua
Department of Gastrointestinal Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Zhonghua Yi Xue Za Zhi. 2009 May 12;89(18):1264-8.
To compare the clinicopathologic parameters of gastric carcinoma between different phases and to investigate the prognostic factors for gastric carcinoma.
A total of 1016 consecutive gastric cancer patients were divided into two groups according to operating date, phase I (1994 - 1996) and phase II (2000 - 2006). The clinicopathologic parameters and prognosis were compared between the two phases. The prognostic factors were analyzed and compared.
There were significant differences in the constituent ratio of male and female patients, the proportions of early gastric carcinoma, different TNM staged patients, specialized operation and adjuvant chemotherapy (all P < 0.05), but no significant differences in tumor location, peritoneal spread, lymph node metastasis and radical resection between the two phases. The overall 5-year survival rate and 5-year survival rate after curative resection were 48.1% and 61.5% respectively within phase II, significantly higher than 32.8% and 42.4% within phase I (all P < 0.01). Stratification analysis revealed that the survival rates of patients with curative resection, lymph node metastasis or not, advanced disease, different TNM stages, specialized operation, without adjuvant chemotherapy within phase II, were significantly higher than those within phase I (all P < 0.01). Multivariant regression analysis revealed that Borrmann type, histological type, depth of invasion, lymph node metastasis, curative resection, adjuvant chemotherapy and different phase were independent prognostic factors for gastric carcinoma.
The therapeutic efficacy of gastric carcinoma within phase II was improved greatly as a result of elevated diagnostic rate of early gastric cancer, standardized radical operation and adjuvant chemotherapy. Gastric carcinoma within phase II was improved highly. It was elevated diagnostic rate of early gastric cancer, standardized radical operation, and adjuvant chemotherapy that contribute to such improvement.
比较不同时期胃癌的临床病理参数，并探讨胃癌的预后因素。
将1016例连续的胃癌患者根据手术日期分为两组，I期（1994 - 1996年）和II期（2000 - 2006年）。比较两个时期的临床病理参数和预后。分析并比较预后因素。
两个时期的男女患者构成比、早期胃癌比例、不同TNM分期患者比例、规范化手术及辅助化疗情况均有显著差异（均P < 0.05），但肿瘤部位、腹膜播散、淋巴结转移及根治性切除情况无显著差异。II期总体5年生存率及根治性切除术后5年生存率分别为48.1%和61.5%，显著高于I期的32.8%和42.4%（均P < 0.01）。分层分析显示，II期根治性切除患者、有无淋巴结转移患者、进展期患者、不同TNM分期患者、规范化手术患者、未行辅助化疗患者的生存率均显著高于I期（均P < 0.01）。多因素回归分析显示，Borrmann分型、组织学类型、浸润深度、淋巴结转移、根治性切除、辅助化疗及不同时期是胃癌的独立预后因素。
由于早期胃癌诊断率提高、规范化根治手术及辅助化疗，II期胃癌的治疗效果有了很大改善。II期胃癌有了显著提高。早期胃癌诊断率提高、规范化根治手术及辅助化疗促成了这种改善。
