论文部分内容阅读
目的:探讨肿瘤直径对胃癌患者预后判断的价值。方法:回顾性分析在南京医科大学第一附属医院接受手术和化疗的胃癌患者共489例,通过统计学方法分析肿瘤直径对胃癌预后的影响。结果:影响患者生存的肿瘤直径最佳截断值是3 cm,据此将患者分为2组:小病灶组(small size group,SSG)直径<3 cm,大病灶组(large size group,LSG)直径≥3 cm,肿瘤直径与分化程度、神经脉管侵犯、浸润深度、淋巴结转移数目及TNM分期密切相关。单因素分析显示SSG组患者的中位生存时间及5年生存率明显优于LSG组患者。多因素COX回归分析显示肿瘤直径与大体分型、肿瘤浸润深度、淋巴结转移、远处转移情况均是影响胃癌患者生存的独立预后因素。T2、T3期SSG组患者生存率明显高于LSG组。结论:对于胃癌患者,肿瘤直径是判断预后重要的参数,可作为生存的独立预后因素。
Objective: To investigate the value of tumor diameter in prognosis of gastric cancer. Methods: A total of 489 gastric cancer patients undergoing surgery and chemotherapy in the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. The effect of tumor diameter on the prognosis of gastric cancer was analyzed by statistical methods. Results: The best cut-off value of tumor diameter influencing patient survival was 3 cm. Patients were divided into 2 groups according to the following criteria: diameter of small size group (SSG) <3 cm, large size group (LSG) The diameter of tumor was more than or equal to 3 cm. The diameter of tumor was closely related to the degree of differentiation, invasion of vascular vessel, depth of invasion, lymph node metastasis and TNM stage. Univariate analysis showed that the median survival time and 5-year survival rate of SSG patients were significantly better than those of LSG patients. Multivariate COX regression analysis showed that tumor diameter and general classification, depth of tumor invasion, lymph node metastasis and distant metastasis were all independent prognostic factors for survival of gastric cancer patients. The survival rates of patients in the T2 and T3 SSG groups were significantly higher than those in the LSG group. Conclusion: For gastric cancer patients, tumor diameter is an important parameter for prognosis, and can be used as an independent prognostic factor for survival.