早期胃癌临床病理特征与预后因素的分析

目的：探讨早期胃癌临床病理特征与预后的关系。方法：采用单因素与多因素的分析方法，回顾性分析1994年至2000年间在我院接受手术且有完整临床资料和随访结果的137例早期胃癌病人的临床病理特征及其对预后的影响。结果：单因素分析显示肿瘤大小、浸润深度及淋巴结转移与早期胃癌的预后相关。多因素分析提示淋巴结转移是早期胃癌预后的独立危险因素。在本组无淋巴结转移的早期胃癌病人中，其术后5年生存率为93．2％，显著优于淋巴结转移者；其中有1～3枚淋巴结转移者，术后5年生存率为88．9％；有4枚及以上淋巴结转移者．术后5年生存率仅为30％，（P〈0．05）。血行转移是早期胃癌病人术后复发的主要类型。结论：淋巴结转移是影响早期胃癌预后的重要指标，术前评估早期胃癌的淋巴结转移状态有助于选择合理的治疗方案。应重视早期胃癌病人的术后随访。

Clinicopathological characteristics of early gastric cancer and its prognostic factors

Objective To explore the relationship between the clinicopathologic characteristics and prognosis of early gastric cancer. Methods The clinical data of 137 early gastric cancer patients undergoing surgical resection were retrospectively analyzed. Univariate and multivariate analysis were used to study the relationship between the clinicopathologic characteristics and the outcome of the patients. Results Univariate analysis demonstrated that tumor size, depth of invasion and status of lymph node metastasis were important prognostic factors of early gastric cancer. Multivariate analysis demonstrated that the status of lymph node metastasis was the only independent prognostic factor. The outcome of patients without lymph node metastasis was significantly better than those with lymph node metastasis. The 5-year survival rates of patients with 1-3 and over 4 metastatic lymph nodes were 88.9% and 30.0% respectively. Hematogenous metastasis was the most common type of recurrence. Conclusions The status of lymph node metastasis is an important prognostic factor of early gastric cancer. Pre-operative staging to predict the status of lymph node metastasis would be valuable to design an appropriate therapeutic strategy. Comprehensive follow-up schedule is also of the outmost importance.