吸烟饮酒对胃癌肝转移及预后影响.docVIP

吸烟饮酒对胃癌肝转移及预后的影响 徐飞华1 魏宜胜2 张畅1 吴雪莲2 陆新容1 (广州医学院第二附属医院 1.护理部 2.胃肠外科 广东 广州 510260) 【摘要】 目的 探讨吸烟饮酒对胃癌肝转移及预后的影响。方法 纳入245例胃癌病例，单因素卡方检验和Logistic多因素检验分析吸烟、饮酒与胃癌肝转移的关系，Cox多因素分析吸烟、饮酒与胃癌总生存的关系。结果 吸烟与胃癌肝转移及总生存无明显相关。与不饮酒者相比，曾经饮酒者明显增加胃癌肝转移的风险(OR=8.92，95%CI=2.81-28.37)；曾经饮酒者总生存也更低(HR=1.81,95%CI=1.10-2.96)。结论 饮酒是影响胃癌患者肝转移及预后的独立危险因素，加强指导患者养成良好的饮食卫生习惯，能降低胃癌肝转移发生的风险。 【关键词】胃癌；肝转移；预后；吸烟；饮酒 The impact of smoking and drinking on liver metastasis and prognosis of gastric cancer XU fei-hua1 ,WEI yi-sheng2, ZHANG chang1,WU xue-lian2,LU xin-rong1 (The second affliated hospital of Guangzhou medical University，Department of Nursing， Department of Gastrointestinal surgery, Guangdong Guangzhou 510260，ChinaTo investigate the impact of smoking and drinking on liver metastasis and prognosis of gastric cancer. Methods There were 245 gastric cancer cases in our study. The associations between smoking，drinking and liver metastasis of gastric cancer were analyzed by single factor Chi-square test and with an unconditional logistic regression model. The associations between smoking， drinking and overall survival of gastric cancer were analyzed by Cox model. Results There was no association between smoking and liver metastasis, overall survival of gastric cancer. Compared with the never drinkers, the ever drinkers had an increased risk of liver metastasis (OR=8.92，95%CI=2.81-28.37) and a worse overall survival(HR=1.81,95%CI=1.10-2.96).Conclusion Drinking is the independent risk factor for liver metastasis and prognosis of gastric cancer. Health education should be improved. 【Key word】Gastric Cancer；Liver Metastasis；Prognosis；Smoking；Drinking 胃癌发病率在当前世界常见恶性肿瘤中占第4位，高居消化道肿瘤之首，死亡率占恶性肿瘤的第2位[1]，严重危害着人民的健康。虽然目前胃癌的治疗手段和水平已有很大提高，但死亡率仍居高不下。其中胃癌复发及转移是影响其预后的主要原因。肝是胃癌转移的最常见部位，胃癌肝转移的发生率约占5%-29%[2]。流行病学研究显示饮酒、吸烟等对胃肠癌等恶性肿瘤发生有明显影响[3-6]，但对胃癌肝转移及预后的影响尚未见报道。本研究拟以南方胃癌人群为样本，探讨饮酒、吸烟等生活习惯对胃癌肝转移及预后的影响。 1 材料与方法 病例来源 本研究病例组来源于2003年1月至2011年12月间广州医学院第二附属医院胃癌病人，共245例。所有病人均接受外科手术有病理证实，术后均接受FOLFOX化疗，均为汉族并且无血缘关系，均来