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[目的]探讨影响胃癌根治术患者预后的临床因素并建立预后预测模型。[方法]收集2004年1月1日～2009年12月30日期间在徐州医学院附属医院行胃癌根治性切除术患者的临床病理资料,并回顾性随访其生存情况。采用Kaplan-Meier法计算生存率,Log-Rank时序检验进行单因素分析,比例风险模型(Cox模型)进行多因素分析比较,采用对数累积风险函数图法(LLS图)检验Cox模型等比例风险假定(PH假定),建立预后指数(PI)方程,计算个体的期望生存率。[结果]胃癌根治术患者1、3、5年生存率分别为80.6%、49.5%、35.5%;分化程度、pTNM分期、肿瘤大小、是否接受辅助化疗4个因素进入胃癌预后的Cox模型,并满足PH假定,成为胃癌根治术患者独立的预后因素。对不同PI值分组,组间生存率差异有统计学意义(P﹤0.01);根据ROC曲线工作原理,选择PI=-0.07为基准,估计样本中个体期望生存率。[结论]分化程度、pTNM分期、肿瘤大小、是否接受辅助化疗为胃癌根治术患者独立的预后因素,PI值可有效的预测胃癌根治术患者的长期生存时间。
[Objective] To explore the clinical factors affecting the prognosis of patients with gastric cancer and to establish a prognostic model. [Methods] The clinical and pathological data of patients undergoing radical resection of gastric cancer at Xuzhou Medical College Affiliated Hospital from January 1, 2004 to December 30, 2009 were collected and their survival was retrospectively reviewed. The Kaplan-Meier method was used to calculate the survival rate and the Log-Rank time series test was used to perform the univariate analysis. The proportional hazard model (Cox model) was used for multivariate analysis and comparison. The cumulative risk function graph (LLS) Assuming (PH hypothesis), a prognostic index (PI) equation is established to calculate the individual’s expected survival. [Results] The 1, 3, 5-year survival rates of patients with gastric cancer were 80.6%, 49.5% and 35.5%, respectively. Differentiation degree, pTNM stage, tumor size, and the presence or absence of adjuvant chemotherapy entered the Cox model of gastric cancer prognosis Meet the PH hypothesis, a radical prognostic factor for gastric cancer patients. According to the working principle of ROC curve and PI = -0.07, the expectation survival rate was estimated based on the working principle of ROC curve. [Conclusion] The degree of differentiation, the stage of pTNM, the size of tumor, whether adjuvant chemotherapy is an independent prognostic factor in patients with radical gastrectomy, the PI value can effectively predict the long-term survival time of patients undergoing radical gastrectomy.