105例中晚期胃癌综合治疗的疗效及预后因素分析

Efficacy evaluation of comprehensive therapy and prognostic factor analysis in 105 advanced gastric cancer patients

关键词:  胃癌  综合治疗  治疗方式  预后

Key words:  [Key words] advanced gastric cancer  comprehensive therapy  treatment  prognosis

摘要:

[摘要]　目的　观察中晚期胃癌患者综合治疗疗效，探讨影响中晚期胃癌患者的预后因素。　方法　收集2012年1月—2013年1月经组织病理学证实的105例中晚期胃癌患者的临床资料，对影响其预后的因素进行单因素及 Cox 回归模型分析，并根据治疗模式分组，对综合治疗疗效进行评价。　结果　本组病例总的中位生存期为15.663个月，6个月生存率为72.0%，12个月生存率为60.0%。单因素分析显示患者的性别、年龄、辅助检查、肿瘤标志物CEA和肿瘤部位对患者预后的影响均无统计学意义（P值均＞0.05)；病变分期、淋巴结转移数目、组织学分级、组织学分型及治疗方式与预后相关（P值均＜0.05)。COX比例风险模型显示患者的病变分期、治疗方式及组织学分型为影响预后的独立因素。Log-rank检验分析治疗方式中综合治疗组优于单一治疗组，且组间差异有显著性意义。　结论　胃癌患者预后与病变分期、淋巴结转移数目、组织学分级、组织学分型及治疗方式等因素相关，其中病变分期、治疗方式是影响患者生存的独立预后因素。

Abstract:

[Abstract] Objective To investigate prognostic factors and effect of comprehensive therapy in 105 patients with advanced gastric cancer. 　Methods From January 2012 to January 2013, 105 cases of advanced gastric cancer were recruited in the study. The diagnoses were confirmed by pathology and clinical data and survival data were collected. The factors influencing survival were analyzed using univariate (Log-rank) and multivariate (Cox model) methods. The 105 patients were divided into different groups according to treatment model. Effects of comprehensive treatment were evaluated. 　Results The overall median survival time was 15.663 months with 6-month survival rate 72% and 12-month survival rate 60.0%. In a single factor analysis, pathological staging, number of lymph node metastasis, histological grading, histological type and the way of therapy had statistical difference (P<0.05). However sex, age, tumor location, tumor marker and accessory examination did not show statistical significance (P>0.05). In a multi-factor analysis, the way of therapy, pathological staging and histological type were independent prognostic factors in advanced gastric cancer (P<0.05). Log-rank analysis indicated that the comprehensive therapy group had better prognosis than the single treatment group (P<0.05). 　Conclusion The prognosis of patients with advanced gastric cancer depends on pathological staging, number of lymph node metastasis, histological grading, histological type and the way of therapy. Different treatment and pathological staging are important factors affecting prognosis of advanced gastric cancer.