肿瘤大小对T3期胃癌患者预后的影响-肿瘤学专业毕业论文.pdfVIP

肿瘤大小对T3 期胃癌患者预后的影响 中文摘要 目的探讨肿瘤大小对T3 期胃癌患者预后的影响。方法 对408 例T3 期胃癌 患者施行胃癌D2 根治术，应用COX 比例风险模型对肿瘤大小进行最佳截点的筛 选。对全组T3 期胃癌患者的预后因素进行单因素及多因素分析；并对大直径组 及小直径组胃癌患者的预后因素进行多因素分析。结果 408 例T3 期胃癌患者中， 通过COX 比例风险模型得出肿瘤大小的最佳截点为8cm，其中肿瘤大小≥8cm 的 胃癌患者（大直径组）85 例，肿瘤大小＜8cm 的胃癌患者（小直径组）323 例； 大直径组和小直径组术后5 年生存率分别为33.8％、52.2%，二组差异具有统计 学意义(P0.05)。通过 COX 比例风险模型分析显示肿瘤大小、淋巴结转移和 Borrmann 分型是影响全组患者预后的独立因素。BorrmannⅣ型、N2-3 淋巴结转 移是影响大直径组患者预后的独立因素。淋巴结转移是影响小直径组患者预后的 独立因素。结论 肿瘤大小是影响T3 期胃癌患者预后的独立因素。除淋巴结转移 能用于判定肿瘤大小≥8cm 或＜8cm 胃癌患者的预后外，Borrmann 分型对于≥8cm 胃癌患者预后的判定也有一定的帮助。 [关键词] 胃癌；病理学，临床；胃切除术，D ；生存率 2 4 Prognostic significance of tumor size in T3 gastric cancer Abstract Objective To investigate the impact of tumor size on the prognosis of patients with T3 gastric cancer. Methods D2 curative resection was performed on 408 patients with T3 Gastric Cancer. Cox proportional hazards model was used to find the optimal critical point of tumor size. Potential prognostic factors were evaluated by univariate and multivariate analysis for all patients, while multivariate analysis was performed evaluating the prognostic factors for the large size group and the small size group. Results Among 408 patients with T3 Gastric Cancer, COX proportional hazards model showed that 8cm is the optimal critical point of tumor size ，85 patients with tumor size ≥ 8cm (large size group), while 323 patients with tumor size 8cm (small size group); the 5-year survival rate was 33.8% for the large size group and 52.2% for the small size group, with statistical significance (P0.05). COX proportional hazards model showed that lymph node metastasis,