外科理论与实践 ›› 2019, Vol. 24 ›› Issue (01): 40-44.doi: 10.16139/j.1007-9610.2019.01.009

• 论著 • 上一篇    下一篇

吻合口区与非吻合口区残胃癌病人的临床病理及预后比较

华子辰, 汪灵泉, 燕敏, 朱正纲   

  1. 上海交通大学医学院附属瑞金医院外科,上海消化外科研究所,上海市胃肿瘤重点实验室,上海 200025
  • 收稿日期:2018-05-07 出版日期:2019-01-25 发布日期:2019-02-25
  • 通讯作者: 燕敏,E-mail: ym10299@163.com;朱正纲,E-mail: zzg1954@hotmail.com

Comparison of clinicopathological features and prognosis in patients with gastric remnant cancer between anastomotic area and non anastomotic area

HUA Zichen, WANG Lingquan, YAN Min, ZHU Zhenggang   

  1. Shanghai Key La-boratory of Gastric Neoplasms, Department of Surgery, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2018-05-07 Online:2019-01-25 Published:2019-02-25

摘要: 目的: 探讨残胃癌发生位置与其临床病理特征及预后的关系。方法: 回顾性分析2007年1月至2016年12月于我院接受诊治的147例残胃癌病人,吻合口组(90例)和非吻合口组(57例)。比较两组病人的临床病理特征及预后。结果: 与非吻合口组相比,吻合口组的手术间隔时间较长[(245.29±189.53)个月比(157.66±149.11)个月,P=0.004]。初次手术行远端胃切除病人中,吻合口组毕Ⅱ式重建比例较高(71.4%比 42.9%,P=0.001)。吻合口组根治性手术的比例较低(67.8%比84.2%,P=0.027)。吻合口组病人远处转移比例较高(31.1%比12.3%,P=0.009)。吻合口组与非吻合口组的3年生存率分别为30.0%和55.6%(P=0.006),5年生存率分别为4.4%和28.1%(P<0.001)。吻合口组的预后较差。Kaplan-Meier曲线显示,吻合口组的生存时间明显短于非吻合口组(P=0.007)。结论: 与非吻合口区域的残胃癌相比,吻合口区域的残胃癌TNM分期较晚、远处转移较多、根治性切除率较低、预后较差。

关键词: 残胃癌, 发生部位, 吻合口, 预后

Abstract: Objective To investigate the location of gastric remnant cancer associated with clinicopathological features and prognosis of the patients with gastric remnant cancer. Methods Retrospective analysis was performed for 147 patients with gastric remnant cancer dividing into anastomotic group (90 cases) and non anastomotic group (57 cases) based on tumor in anastomotic area or not, who admitted to Ruijin Hospital Shanghai Jiao Tong University School of Medicine from January 2007 to December 2016. Clinicopathological characteristics and prognosis were compared between two groups. Results The patients in anastomotic group had longer interval from initial partial gastrectomy than that of patients in non anastomotic group [(245.29±189.53) months vs (157.66±149.11) months, P=0.004]. Patients in anastomotic group were associated with higher reconstruction of Billroth Ⅱ (71.4% vs 42.9%, P=0.001), higher distant metastasis (31.1% vs 12.3%, P=0.009) and lower rate of radical surgery (67.8% vs 84.2%, P=0.027) compared with patients in non anastomotic group. Three year survival rates was 30.0% and 55.6% for anastomotic group and non anastomotic group (P=0.006) and 5 year survival rate 4.4% and 28.1% respectively (P<0.001). It was shown by Kaplan-Meier curve that survival duration was significantly shorter in anastomotic group than in non anastomotic group (P=0.007). Conclusions Gastric remnant cancer located at anastomotic area was in later TNM staging, more distant metastasis, lower rate of radical resection and poorer prognosis compared with those at non anastomotic area.

Key words: Gastric remnant cancer, Tumor location, Anastomotic site, Prognosis

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