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目的:研究新疆地区胃癌根治术后患者的临床因素以及术后治疗对预后产生的影响。方法:对2003-01-2009-12新疆医科大学第一附属医院收治的胃癌根治术后患者164例进行回顾性分析,采用Kaplan-Meier法计算患者的生存率,用Log-rank检验进行单因素分析,应用Cox模型进行预后的多因素分析。结果:共82例患者死亡,中位随访时间28.0个月,1年累积生存率为78.7%(129/164),3年为42.1%(69/164),5年为6.7%(11/164),中位生存时间40.1个月。单因素分析显示,性别、民族、临床分期、浸润深度、淋巴结转移、网膜转移、组织学分化、肿瘤部位、切缘残留、肿瘤大小、脉管侵犯和术后治疗情况与预后相关,P<0.05;多因素分析证实,网膜转移(RR=8.564,P<0.01)、淋巴结转移(RR=4.092,P<0.01)、切缘残留(RR=3.282,P=0.002)、民族(RR=2.152,P=0.013)、浸润深度(RR=2.071,P=0.022)和肿瘤部位(RR=0.680,P=0.010)是影响胃癌预后独立的危险因子。结论:胃癌根治术后影响预后的独立因素按RR从高到低依次为网膜转移、淋巴结转移、切缘残留、民族、浸润深度和肿瘤部位。
Objective: To study the clinical factors of patients with radical resection of gastric cancer in Xinjiang and the effect of postoperative treatment on prognosis. Methods: A retrospective analysis of 164 patients with radical gastrectomy admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2003 to December 2009 was conducted. The Kaplan-Meier method was used to calculate the survival rate of patients. Log-rank test was used to determine the single factor Analysis, the use of Cox model for prognosis of multivariate analysis. RESULTS: A total of 82 patients died with a median follow-up of 28.0 months. The 1-year cumulative survival rate was 78.7% (129/164), 42.1% (69/164) for 3 years and 6.7% for 5 years ), The median survival time 40.1 months. Univariate analysis showed that gender, ethnicity, clinical stage, depth of invasion, lymph node metastasis, omentum metastasis, histological differentiation, tumor location, residual margin, tumor size, vascular invasion and postoperative treatment were correlated with prognosis, P < 0.05). Multivariate analysis showed that there were significant differences in the incidence of retinal metastasis (RR = 8.564, P <0.01), lymph node metastasis (RR = 4.092, , P = 0.013). The depth of invasion (RR = 2.071, P = 0.022) and tumor location (RR = 0.680, P = 0.010) were independent risk factors for prognosis of gastric cancer. Conclusion: The independent factors influencing the prognosis of gastric cancer after radical resection were as follows: omentum metastasis, lymph node metastasis, residual margins, ethnicity, depth of invasion and tumor site.