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目的:分析Krukenberg瘤患者的临床病理特点,寻找影响肿瘤发生和预后的相关因素。方法:回顾性分析139例确诊Krukenberg瘤的临床病理特点,重点考察年龄、原发瘤部位、临床表现、影像学、实验室检查、治疗及预后,进行多因素分析。结果:患者年龄13-73岁,中位数42岁;原发瘤为胃癌70例(50.36%),结肠癌28例(20.14%),直肠癌25例(17.99%),不明者16例(11.51%);116例有详细转移灶资料,双侧转移64例(55.17%),单侧转移52例(44.83%);53例有肿瘤标志物检验结果,CA125升高35例(66.04%),CEA升高25例(47.17%),CA199升高15例(28.30%),CA153升高4例(7.55%)。22例有完整生存资料,生存期0-55月,中位生存期11.5月。COX比例风险模型多因素分析显示年龄、治疗方案为影响预后的主要因素(似然比χ2=11.540,P<0.05),手术联合放疗能改善生存(P<0.05,β=-2.288),而原发瘤部位、大小、浸润深度、淋巴结数目、卵巢肿瘤偏侧性、体积、肿瘤分化程度、腹水等对预后的影响无统计学意义。结论:多数Krukenberg瘤在原发瘤手术2年内发生,主要预后因素是年龄和治疗方案,手术加放疗对改善生存有益。
OBJECTIVE: To analyze the clinicopathological features of Krukenberg tumor in order to find out the relevant factors that affect tumorigenesis and prognosis. Methods: The clinicopathological characteristics of 139 cases diagnosed with Krukenberg’s tumor were retrospectively analyzed. Multivariate analysis was performed on the age, primary tumor site, clinical manifestations, imaging, laboratory tests, treatment and prognosis. Results: The patients were 13-73 years old with a median of 42 years old. The primary tumors were 70 cases of gastric cancer (50.36%), 28 cases of colon cancer (20.14%), 25 cases of rectal cancer (17.99%) and 16 cases of unknown 11.5%). In 116 patients with metastatic disease, 64 patients (55.17%) had bilateral metastasis and 52 patients (44.83%) had unilateral metastasis. Totally 53 patients had tumor marker test results. CA125 increased in 35 patients (66.04% , CEA increased in 25 cases (47.17%), CA199 increased in 15 cases (28.30%) and CA153 increased in 4 cases (7.55%). Twenty-two patients had complete survival data, with a survival of 0-55 months and a median survival of 11.5 months. Multivariate analysis showed that age and treatment regimen were the main factors influencing prognosis (likelihood ratio χ2 = 11.540, P <0.05), and surgery combined with radiotherapy improved survival (P <0.05, β = -2.288) Tumor site, size, depth of invasion, the number of lymph nodes, ovarian tumor laterality, volume, degree of tumor differentiation, ascites and other prognosis had no statistical significance. CONCLUSION: Most Krukenberg tumors occur within 2 years of primary tumor surgery. The primary prognostic factors are age and treatment regimens. Surgery plus radiotherapy is good for improving survival.