乳腺癌合并2型糖尿病患者的临床特征及预后

背景与目的:近年来糖尿病患者恶性肿瘤发生率明显增加,乳腺癌也不例外;对于糖尿病和乳腺癌的关系,许多研究提示糖尿病是乳腺癌的高危因素之一.而目前对于合并糖尿病是否会影响乳腺癌的预后的认识还无明确结论.本研究旨在探讨乳腺癌合并2型糖尿病患者的临床预后.方法:采用病例对照的方法分析同时期住院的合并有2型糖尿病或高血压的乳腺癌患者(后者为对照组)之间的预后差异,应用统计学方法进行生存分析及Cox回归模型进行单因素和多因素分析.结果:2型糖尿病乳腺癌组的复发转移率19%,对照组复发转移率9.3%,两组无复发转移生存率比较差异有统计学意义;多因素回归分析显示是否伴有糖尿病、淋巴结状态及ER(estrogen receptor,雌激素受体)状态是乳腺癌复发转移的独立危险因素.分层分析发现,2型糖尿病患者在淋巴结阳性亚组、ER阳性或阴性亚组及接受化疗组中均显示了显著预后价值,但在淋巴结阴性亚组及未接受化疗亚组中,差异未达统计学意义.结论:2型糖尿病是乳腺癌患者复发和转移的独立预后危险因素;合并有2型糖尿病的乳腺癌患者需要更合理的治疗方式.     

Oncotype DX 21基因检测在ER阳性早期乳腺癌中的应用

在诸多评估雌激素受体(estrogen receptor,ER)阳性早期乳腺癌复发风险的多基因工具中,Oncotype DX 21基因检测因其独特的疗效预测作用而被广泛应用于淋巴结阴性患者.多项回顾性研究已证明其在淋巴结阳性人群同样具有预后预测价值,但前瞻性临床试验证据仍不充分.该检测能协同其他重要临床病理因素,影响乳腺癌患者的辅助治疗方案,且具较高的成本效益.该研究就21基因检测对早期乳腺癌患者的预后预测价值、独特优势、辅助治疗决策影响、成本效果和现存争议进行综述.     

术前BMI对未复发乳腺癌患者总生存期的影响

目的:探讨在可手术乳腺癌患者中,术前体脂肪健康指数(body mass index,BMI)对未复发患者总生存期(overall survival,OS)的影响.方法:回顾性分析2005年1月至2009年12月接受乳腺癌手术治疗的女性未复发患者1 498例,分别对绝经前组和绝经后组进行生存分析.结果:绝经前未复发乳腺癌患者中,TNM分期早、淋巴结转移数少、ER阳性、PR阳性的患者较TNM分期晚、淋巴结转移数多、ER阴性、PR阴性的患者OS更长(P＜0.05);绝经后乳腺癌患者中,TNM分期早、淋巴结转移数少、ER阳性、Ki-67阴性较TNM分期晚、淋巴结转移数多、ER阴性、Ki-67阳性的患者OS更长;在绝经后未复发乳腺癌患者中,超重或肥胖患者较正常体重患者OS长,低体重患者OS最短.结论:对绝经后的乳腺癌幸存者而言,术前BMI＜ 18.5kg/m2的患者总生存预后不好.足够的营养和控制体重同等重要.     

腋窝淋巴结阴性乳腺癌206例预后因素分析

目的探讨腋窝淋巴结阴性乳腺癌的临床特点、治疗方法及预后的影响因素。方法收集206例腋窝淋巴结阴性乳腺癌患者的临床病理资料,应用Kaplan-Meier法计算生存率,应用log-rank检验各组生存率,采用COX比例风险模型进行多因素分析。结果全组患者5年无复发生存率为83.5%,总生存率为95.6%。单因素分析显示,年龄（P=0.0137）、肿块大小（P=0.0002）、术后放疗（P=0.0176）、化疗（P=0.0104）、内分泌治疗（P=0.0091）是影响淋巴结阴性乳腺癌患者5年无病生存的因素;年龄（P=0.0113）、肿块大小（P=0.0375）、ER（P=0.0046）、PR（P=0.0275）是影响淋巴结阴性乳腺癌患者5年总生存的因素。多因素分析显示,肿块大小（P=0.002）是影响淋巴结阴性乳腺癌患者5年无病生存的独立预后因素。结论肿块大小是影响淋巴结阴性乳腺癌患者5年无病生存的独立预后因素。     

雌激素受体阳性乳腺癌预后的相关因素分析

目的 探讨影响雌激素受体（ER）阳性乳腺癌患者预后的因素。 方法 收集2006年1月至2009年11月诊治的229例ER阳性乳腺癌患者的临床和随访资料,分析其临床病理参数中与预后相关的因素。将发病年龄、月经状况、肿瘤大小、淋巴结转移率（LNR）、PR表达、Her-2表达、组织学分级、新辅助化疗及放疗等因素进行Kaplan-Meier单因素和Cox回归多因素生存分析。 结果 获随访的223例患者的复发率为15.70％。Cox模型多因素生存分析显示：肿瘤大小、LNR、Her-2表达及PR表达均为影响ER阳性患者接受内分泌治疗后无复发生存的独立因素（P＜0.05）。 结论 肿瘤越大、Her-2过表达、PR阴性及LNR较高是ER阳性乳腺癌复发转移的独立危险因素。     

淋巴结阴性的乳腺癌DNA含量检测的意义

淋巴结转移与否常作为判断治疗后预后的主要因素,然而在淋巴结阴性的病人中亦有部份病人出现复发或远处转移。对这些病人如果手术后选用辅助治疗可能提高其生存率,因而如何在病理上淋巴结没有转移的病人中发现哪些具有高危险复发因素的病人,是提高疗效的关键。本文应用FCM检测55例淋巴结无转移的乳腺癌患者的原发病灶的DNA含量,并同时测定其腋淋巴结的DNA含量和原发病灶的激素受体ER和PgR状态,通过30月的随访资料,以评价DNA含量的测定在淋巴结无转移乳腺癌患者的价值。     

乳腺癌根治术局部复发后影响预后的相关因素分析

目的研究乳腺癌根治术局部复发后影响预后的相关因素,探讨乳腺癌根治术后局部复发的最佳治疗方案。方法回顾性分析天津肿瘤医院1975年1月至2003年1月期间收治的1067例乳腺癌根治术后复发患者,采用χ2检验或秩和检验对患者年龄、绝经情况、原发瘤临床分期、腋窝淋巴结转移情况、无病间期、复发部位、胸壁复发灶数目及其最大直径、雌激素受体(ER)或孕激素受体(PR)表达、人类表皮生长因子受体2(HER-2)表达等临床病理特征以及不同治疗方案与局部复发治疗的近期疗效和远处转移率之间的关系进行单因素分析;使用Kaplan-Meier法及COX回归模型对乳腺癌根治术复发后影响5年生存率的相关因素进行单因素与多因素分析。结果对全部1067例病例进行随访,778例(72.9%)出现远处转移,复发后5年总生存率为42.4%。复发部位、胸壁复发灶数目及其最大直径、有无放射治疗、放射治疗范围、有无化疗、有无手术切除或切除活检等因素的不同亚组间局部控制率的差异有统计学意义(P0.050);腋窝淋巴结转移情况、无病间期、ER或PR表达、HER-2表达以及再治疗中有无化疗等因素的不同亚组间远处转移率的差异有统计学意义(P0.050);无病间期、复发部位、胸壁复发灶数目、ER或PR表达、HER-2表达、治疗方法等因素的不同亚组间5年总生存率的差异有统计学意义(P0.050);无病间期≤2年、复发部位多、治疗方案单一、局部控制率低及ER、PR均阴性是导致复发性乳腺癌预后差的独立因素(P0.050)。结论多部位复发、胸壁多发结节及胸壁复发灶最大直径3cm者局部控制不佳,局部扩大野放射治疗结合化疗和(或)手术是改善局部控制率的较好模式;有腋窝淋巴结转移、2年内复发、ER、PR均阴性以及HER-2阳性表达的乳腺癌复发后容易发生远处转移,复发再治疗中化疗能减少远处转移的发生;对于复发性乳腺癌采取综合治疗方案可以提高复发患者的生存率;无病间期长,多部位复发,ER或PR阴性者提示预后不良。     

乳腺癌腋淋巴结隐匿性转移的预后

乳腺癌病理检查腋淋巴结转移状况是决定分期、病人预后和指导术后辅助治疗的一个最重要的指标［１］。寻找腋淋巴结阴性乳腺癌病人的预后指标以指导术后辅助治疗是乳腺癌研究领域的一大热点。本文研究常规病理检查诊断为腋淋巴结阴性乳腺癌（ＡＮＮ）病人其腋淋巴结隐匿性...     

73例乳腺癌术后胸壁复发因素及预后分析

目的:探讨乳腺癌术后胸壁局部复发因素及预后意义.方法:对73例乳腺癌术后胸壁复发患者进行回顾性分析.结果:本组患者占同期全部乳腺癌病例的4.02%,其中50例(68.5%)胸壁复发发生在术后2年内,复发后34例(46.6%)于2年内死亡.结论:乳腺癌原发肿瘤分期晚、腋下淋巴结癌转移数多、复发率高;原发灶雌激素受体(ER)及孕激素受体(PR)阴性患者,复发多出现在术后2年内.术后胸壁复发时,复发病灶情况及治疗效果是影响预后的因素之一,以手术为主的综合治疗可提高其远期疗效.     

mTOR表达与雌激素受体阳性乳腺癌辅助内分泌治疗预后的关系

目的探讨雌激素受体（estrogen receptor,ER）阳性乳腺癌中mTOR蛋白的表达与乳腺癌辅助内分泌治疗预后间的关系。方法采用免疫组化方法检测60例ER阳性且接受内分泌辅助治疗患者的原发乳腺癌组织中p-mTOR蛋白的表达情况,观察mTOR蛋白的表达特点.并分析其与临床特征间的关系及对无病生存的影响。结果 mTOR蛋白强阳性表达的乳腺癌细胞具有更多的组织学恶性特征,mTOR阴性组中位无病生存（56.4个月）显著优于阳性组（33.5个月）（P=0.015）,多因素回归分析中mTOR为阳性者发生肿瘤复发转移的风险比例（HR）是mTOR阴性者的3.212倍,其95%CI为1.291～7.992。结论 mTOR表达状态为ER阳性是乳腺癌复发转移的独立预后因素,提示辅助内分泌治疗联合mTOR抑制剂可为ER阳性乳腺癌患者带来生存获益。     

Prognostic effect of estrogen receptor status across age in primary breast cancer

Estrogen receptor (ER) status is considered as an important prognostic factor as well as a predictive factor for endocrine responsiveness in breast cancer. We analyzed the distribution of ER status across age and estimated variations in the prognostic impact of ER status related to patients' age and time since diagnosis. Overall, 26,944 patients with primary breast cancer diagnosed from 1989 to 2004 were included. The proportion of ER positive tumors increased over age from 51 to 82%. In multivariate analysis of overall survival, ER positive status was found to be a significantly positive prognostic factor over all age groups. This effect was limited to the first 5 years after diagnosis, RR: 2.08 (95% CI: 1.95-2.22, p < 0.0001). Overall survival during the following 5 years was slightly superior for women with ER negative tumors, RR of death: 0.89 (95% CI: 0.79-1.00, p = 0.049). Results were unchanged in patients who did not receive adjuvant systemic therapy (n = 6,272). Thus, positive ER status does not confer a negative impact on survival in young women as has been previously reported. The inferior prognosis for ER negative patients during the first 5 years after diagnosis changes into a slightly superior residual prognosis compared to ER positive patients independent of use of adjuvant systemic therapy. This may have an impact on future designing of guidelines for adjuvant endocrine therapy beyond 5 years.     

Identifying good prognosis group of breast cancer patients with 1-3 positive axillary nodes for adjuvant cyclophosphamide, methotrexate and 5-fluorouracil (CMF) chemotherapy

OBJECTIVE: We conducted a retrospective analysis of prognosis factors for survival in breast cancer patients with 1-3 axillary lymph node metastases and tried to identify a subset of patients with good prognosis suitable for cyclophosphamide, methotrexate and 5-fluorouracil (CMF) adjuvant chemotherapy. METHODS: A cohort of 446 breast cancer patients received definite surgery and adjuvant chemotherapy with CMF at Chang Gung Memorial Hospital from 1990 to 1998. They were enrolled in the study. The median follow-up time was 69 months. Prognostic factors including age, tumor size, number of involved nodes, steroid receptor status, tumor ploidy, synthetic-phase fraction, histologic grade and administration of tamoxifen were analysed for disease-free survival (DFS) and overall survival (OS) by Cox regression model. RESULTS: The estimated 5 year OS and DFS for all patients were 85.4 and 71.5%, respectively. Multivariate analysis revealed that tumor size, age and estrogen receptor (ER) status were independent prognostic factors for OS, and tumor size, age, ER status and number of involved nodes were independent prognostic factors for DFS. The 5 year OS rates of the low-risk group (age >40, tumor < or =3 cm and positive ER) and average-risk group (either age < or =40, tumor >3 cm or negative ER) were 98.8 and 82.4%, respectively (P = 0.0001). The 5 year DFS of the low-risk and high-risk group were 88.2 and 67.7%, respectively (P = 0.0001). CONCLUSION: Among breast cancer patients with 1-3 positive lymph nodes excellent survival rate was found in those who had favorable prognostic factors, including age >40, tumor size < or =3 cm and positive ER. Adjuvant chemotherapy with CMF regimen is optimal for these low-risk patients.     

A Comprehensive Model for Predicting Recurrence and Survival in Cases of Chinese Postoperative Invasive Breast Cancer

We investigated relationships between clinical pathologic data, molecular biomarkers and prognosis of invasive breast cancer based on a Chinese population. Immunohistochemistry (IHC) was used to assess the status of ER, PR, HER-2 and Ki-67, with fluorescence in situ hybridization (FISH) performed to further confirm HER-2 positivity with an equivocal result (IHC 2+). Subsequently, Kaplan-Meier univariate and multivariate COX regression analyses of ER, PR, HER-2, Ki-67, clinical features, therapeutic status and follow-up data were performed according to the establishment principle of the Nottingham prognostic index (NPI). From this study, age, tumor size, lymph node status, ER, HER-2, Ki-67 status were found to be associated with prognosis. Eventually, a prognostic model of (PI= (1.5×age) - size + (0.1×lymph node status) - (0.5×ER) + (2×HER-2) - (0.2×Ki-67)) was established with 288 randomly selected patients and verified with another 100 cases with invasive breast cancer. Pearson correlation analysis demonstrated a significant positive correlation index of 0.376 (P=0.012<0.05) between the prognostic index (PI) and actual prognosis. Remarkably, the consistency with the model predicted recurrence was 93% in the validation set. Therefore, it appears feasible to predict the prognosis of individuals with invasive breast cancer and to determine optimal therapeutic strategy with this model.     

贵州省720例乳腺癌HER-2的表达情况及抗HER-2治疗的回顾性分析

背景与目的：乳腺癌是严重威胁女性生命的恶性肿瘤之一,在我国汉族与其他少数民族乳腺癌的发病率及其HER-2基因表达差异成为学者关注的问题。该研究旨在分析贵州省乳腺癌HER-2基因表达的民族差异性,评价应用曲妥珠单抗行分子靶向治疗的临床疗效,探讨多种临床因素对贵州省乳腺癌患者生存预后的影响。方法：回顾性分析2007年1月—2013年12月在贵州医科大学附属肿瘤医院接受治疗的720例女性乳腺癌患者的随访情况,采用SPSS 17.0中的Kaplan-Meier法对患者进行生存分析,统计患者无病生存期(disease free survival,DFS)及总生存期(overall survival,OS),采用Log-rank检验进行因素间比较。采用Cox回归模式进行多因素检验,分析乳腺癌的独立预后因素。结果：入组的720例患者中,HER-2阴性表达520例(72.2%),HER-2阳性表达200例(27.8%)。200例HER-2阳性乳腺癌患者中,汉族177例(177/645,27.4%),少数民族23例(23/75,30.7%)。200例HER-2阳性乳腺癌患者中,行抗HER-2治疗37例(18.5%),未行抗HER-2治疗163例(81.5%),可分为治疗组及对照组。统计分析显示,治疗组与对照组的DFS和OS差异均有统计学意义(P=0.041和0.022)。Cox回归分析提示,雌激素受体(estrogen receptor,ER)和Ki-67是入组乳腺癌患者的独立预后因素(P=0.03和0.016),孕激素受体(progesterone receptor,PR和HER-2不是独立预后因素(P均>0.05);其中汉族乳腺癌患者的ER和Ki-67是独立预后因素(P=0.018和0.031),PR和HER-2不是独立预后因素(P均>0.05);少数民族乳腺癌患者的ER、PR、HER-2和Ki-67均不是独立的预后因素(P均>0.05)。结论：HER-2基因阳性表达不具有民族差异性。HER-2阳性患者应用曲妥珠单抗行抗HER-2治疗可明显改善预后,延长DFS及OS,但目前贵州省行抗HER-2治疗人群不足20%。本研究初步提示ER、Ki-67作为乳腺癌独立的预后因素具有民族差异性的趋势。     

E R阳性乳腺癌中FGFR1蛋白的表达与ER及预后的关系

背景与目的：乳腺癌是严重危害女性健康的常见恶性肿瘤之一，内分泌治疗是乳腺癌综合治疗中的重要措施之一。约30%激素敏感型乳腺癌患者并不能从内分泌治疗中获益。成纤维细胞生长因子受体1（fibroblast growth factor receptors 1，FGFR1）的表达与雌激素受体（estrogen receptor，ER）阳性乳腺癌患者内分泌治疗耐药可能有关。该研究旨在探讨ER阳性乳腺癌中FGFR1蛋白的表达水平对乳腺癌临床病理学特征及预后的影响。方法：选取哈尔滨医科大学附属肿瘤医院2008年9月-2011年12月收治的184例ER阳性乳腺癌患者，通过免疫组织化学方法检测FGFR1蛋白的表达；采用χ²检验评估FGFR1蛋白水平与乳腺癌临床病理学特征的关系；采用Spearman相关分析评估变量间是否存在相关性；运用COX回归及Kaplan-Meier法分析FGFR1表达水平对乳腺癌预后的影响。结果：在ER阳性乳腺癌中，FGFR1高表达的患者更易发生区域淋巴结转移（P=0.012，r=0.186），且FGFR1的表达水平与ER的表达水平之间存在显著的负相关关系（P=0.011，r=-0.221）。COX单因素分析显示，TNM分期、区域淋巴结转移情况、Ki-67阳性率及FGFR1表达情况与ER阳性乳腺癌预后有关；进一步进行多因素分析发现，淋巴结转移情况（OR=1.744，95%CI：1.002~3.034，P=0.049）和Ki-67阳性率（OR=1.882，95%CI：1.015~3.491，P=0.045）是ER阳性乳腺癌的独立风险因素。Kaplan-Meier生存分析提示，FGFR1高表达患者预后不良（P=0.036）。结论：在ER阳性乳腺癌中，FGFR1蛋白水平与患者ER的表达水平呈显著负相关，且FGFR1高表达提示患者预后不良。     

Prognostic and predictive factors in the adjuvant treatment of breast cancer

The selection of systemic adjuvant therapy should be based on the appropriate prognostic and predictive factors. The established prognostic factors currently used in cases of primary breast cancer include axillary lymph node involvement, histologic subtype, tumor size, nuclear or histologic grade, estrogen (ER) and progesterone receptor (PR) status and proliferative index. Adjuvant chemotherapy has had an impact on the management of node-positive breast cancer, while the St. Gallen recommendations were established for postoperative adjuvant therapy for node-negative breast cancer. However, there is some contention regarding the histological (or nuclear) grading systems among different pathologists. With regard to biological measurements, the most useful prognostic/predictive factors are hormone receptor status and HER-2 overexpression. ER and PR status can be used to establish the necessity of hormone therapy in the adjuvant setting. If the anti-HER-2 antibody and/or antiangiogenic agents are introduced into the adjuvant setting in the near future, determination of these factors is also recommended.     

Tumor angiogenesis in node-negative breast carcinomas — relationship with epidermal growth factor receptor,estrogen receptor,and survival

Summary Angiogenesis is essential for tumor growth and metastases. Studies in breast carcinomas suggest that microvessel quantitation as a measure of angiogenesis might be one of the most powerful prognostic tools available. Node negative breast cancer is a particular group for which better prognostic markers would be helpful. We therefore measured microvessel density in a series of well characterised node negative breast carcinomas to evaluate angiogenesis as a prognostic marker and assess its relationship to epidermal growth factor receptor (EGFR) and estrogen receptor (ER), which have previously been reported to be of value. 109 patients with a mean age of 55 years and a median follow-up of 25 months were examined. Vessels were immunohistochemically highlighted using an antibody to platelet endothelial cell adhesion molecule CD31, and microvessel density was quantified using a Chalkley point eyepiece graticule. No significant correlation was observed with patient age, tumor size, grade, ER, or EGFR expression. In a univariate analysis of survival, whereas ER expression was not a significant indicator of either relapse-free (RFS) or overall survival (OS), vascular count (VC) predicted both early RFS and OS (p=0.01 and p=0.028 respectively). Furthermore, in patients with ER positive tumors, a subgroup usually considered to have a good prognosis, there was a significant reduction in RFS and OS if tumors had high VCs (p=0.05 and p=0.002 respectively). A further statistically significant reduction in RFS (p=0.05) was observed for EGFR positive highly vascular tumors. In a Cox proportional hazard model, VC remained a significant prognostic indicator for both RFS and OS (p=0.04 and p=0.01) and conferred a 6.6 and 3.5 times respective increased risk of mortality and relapse. These findings suggest that quantitation of angiogenesis is an independent predictor of survival in node negative breast carcinomas, and due to these high hazard ratios might be more useful than other recently described prognostic markers in selecting patients who would benefit from adjuvant therapy.     

Therapeutic strategy for patients with pN0 gastric carcinoma

BACKGROUND AND OBJECTIVES: The prognosis for patients with pN0 gastric cancer is moderately hopeful (expected 5-year survival: 80%). However, the relevant prognostic factors and most appropriate surveillance protocol have not been identified. METHODS: We investigated 733 gastric cancer patients without lymph node metastasis for prognostic factors by uni- and multi-variate analysis and by documenting causes of death and recurrence patterns. RESULTS: Univariate analysis revealed that age, tumor location, macroscopic appearance, tumor diameter, invasion depth, lymphatic invasion, and venous invasion affected prognosis. Multivariate analysis showed that age (> or = 60 years), ill-defined macroscopic appearance, and undifferentiated histological type independently reduced survival rates. Age (> or = 60 years) and undifferentiated histological type adversely influenced prognosis in 507 early gastric cancer patients whereas ill-defined macroscopic appearance adversely affected prognosis in 226 advanced cancer patients. Recurrence patterns in these patients were similar to those produced by lymph node metastasis. The predominant recurrence pattern was peritoneal dissemination, observed 2-3 years post-resection. CONCLUSIONS: This study identified adverse prognostic factors in pN0 gastric cancer patients. Randomized controlled studies of adjuvant chemotherapy are necessary to assess whether such therapy is beneficial for patients with adverse prognostic factors.     

Quantitative measurement of soluble cytokeratin fragments in tissue cytosol of 599 node negative breast cancer patients: a prognostic marker possibly associated with apoptosis

Apoptosis is associated with caspase-mediated proteolysis of Type I (K18 and K19) cytokeratins. We previously showed a positive association between the levels of tissue polypeptide antigen (TPA), that recognizes cytokeratins K8, K18, and K19 fragments, and induced apoptosis in breast cancer cell lines. The aim of the present study was to evaluate the interrelationships between TPA, steroid receptors, and p53, and their joint prognostic role in node-negative breast cancer patients not treated with adjuvant therapies. Age and pT were also considered since they are known prognostic factors. Five hundred and ninety-nine cases with N- breast cancer were evaluated (median follow-up: 60 months). TPA was measured by an immunoradiometric assay and p53 by an immuno-chemiluminescent assay in tumor cytosol. Multiple correspondence analysis was used to study the associations among variables. Their prognostic role (univariate analysis) and their joint effect (multivariate analysis) on RFS were investigated with Cox regression models. TPA showed a direct association with ER and PgR. Higher p53 values were weakly associated to low values of ER, PgR, and TPA. Younger age was related to low and intermediate values of ER and PgR and to low p53 values, while older age was related to high values of ER. Multivariate analysis showed a significant prognostic impact for pT, age, ER, and TPA. Among the interactions considered clinically relevant, only that between ER and age was found. RFS estimated values were poorer in cases with lower than in those with higher TPA values, both in patients expected to have a poor (pT2, young age, low ER) and a better prognosis (pT1, older age, high ER). From the findings of the present study we can draw the following conclusions: The relationship of TPA with prognosis gives an additional contribution to pT, age, and steroid receptors in N- breast cancer; TPA may be considered the first marker of apoptosis measured with a fully standardized quantitative method in tumor cytosol and could be evaluated in prognostic indexes including markers related to different biological mechanisms.     

早期胃癌的临床病理特征及预后分析

目的分析早期胃癌的临床病理特征与预后之间的关系。方法回顾性分析1994年1月至2005年10月间,在我院实施D2根治术且资料完整的255例早期胃癌患者的临床资料,采用Kaplan-Meier法进行生存分析,Logrank检验进行统计学比较,Cox比例风险模型进行多因素分析。结果 255例患者的5年生存率为91.4%。单因素分析显示,肿瘤浸润深度、脉管瘤栓和区域淋巴结转移与患者术后生存率有关;而性别、年龄、肿瘤大小、肿瘤位置、大体类型、分化程度与术后生存率无关。多因素分析显示,区域淋巴结转移是影响预后的独立危险因素。结论伴有区域淋巴结转移的早期胃癌患者预后较差,标准胃癌根治性手术后应接受综合治疗并严密随访。