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目的:分析胃癌术后复发及其影响因素,从而临床诊治提供更多理论依据。方法:收集我院2002年12月-2003年12月期间诊治的胃癌根治术后复发患者60例作为研究对象,采用回顾性的方式分析患者的临床资料,同时采用Logistic回归分析对术后复发及其影响因素进行分析。结果:研究结果显示,本组60名患者平均复发时间为术后20.8个月,其中有46名患者为术后两年内复发,占总数的76.67%,有13名患者为两年至五年内复发,占总数的率为21.67%,另外1名患者为五年后复发,占总数的率1.67%。其中有10名患者为区域局部复发,占总数的16.67%,有37例为腹膜和远处淋巴结转移复发,占总数的61.17%,另外13名患者为血源性转移复发,占总数的21.67%。其中有49名患者为单一复发,占总数的81.67%,另外11名患者为多种复发类型,占总数的18.33%。通过logistic多因素回归分析表明,影响术后复发死亡的独立因素包括病程分期、术后腹腔化疗、TNM分期、术前介入化疗,其中介入化疗和腹腔化疗是保护因素。结论:胃癌根治术后复发主要发生于手术之后两年以内,复发类型主要以腹膜复发为主,术后复发影响因素众多,独立因素起主要作用。
Objective: To analyze postoperative recurrence of gastric cancer and its influencing factors, and to provide more theoretical basis for clinical diagnosis and treatment. Methods: Sixty patients with postoperative recurrence of gastric cancer undergoing radical resection from December 2002 to December 2003 in our hospital were collected. The clinical data of the patients were retrospectively analyzed. At the same time, Logistic regression analysis was used to evaluate the relapse and prognosis Its influencing factors are analyzed. Results: The study showed that the average recurrence time of 60 patients in this group was 20.8 months after operation, of which 46 patients had recurrence within two years after operation, accounting for 76.67% of the total. Thirteen patients relapsed within two years to five years , Accounting for 21.67% of the total number. The other 1 patient relapsed after five years, accounting for 1.67% of the total. Among them, 10 patients were regional recurrences, accounting for 16.67% of the total, 37 cases were retroperitoneal and distant lymph node metastasis recurrence, accounting for 61.17% of the total, the other 13 patients were hematogenous recurrence, accounting for 21.67% . Among them, 49 patients had a single recurrence, accounting for 81.67% of the total. The other 11 patients had multiple recurrence types, accounting for 18.33% of the total. Logistic multivariate regression analysis showed that independent factors affecting postoperative recurrence include stage of disease, postoperative intraperitoneal chemotherapy, TNM staging, preoperative interventional chemotherapy, and interventional chemotherapy and intraperitoneal chemotherapy are protective factors. Conclusion: The recurrence of gastric cancer mainly occurs within two years after operation. The type of recurrence is mainly retroperitoneal recurrence. There are many influencing factors of recurrence after gastric cancer recurrence. Independent factors play a major role.