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临床分期高于病理分期的偏倚影响胃癌根治术后患者预后的临床观察 被引量:6

The clinical observation of the bias of clinical staging higher than pathological staging affected the prognosis of gastric cancer after radical resection
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摘要 目的探讨术前临床分期(c-stage)高于术后病理分期(p-stage)的偏倚对胃癌根治术后预后的影响。方法回顾性分析134例接受根治性手术的胃癌患者的临床病例资料,其中41例存在c-stage高于p-stage。分析这种偏倚与胃癌临床病理特征及总生存(OS)的关系,采用Cox风险比例回归模型分析影响胃癌OS的预后因素。结果c-stage高于p-stage的偏倚与年龄、性别、肿瘤部位、病理T分期无关,而与病理N分期、病理TNM分期及分化程度有关;单因素分析显示,术后病理T分期、N分期、TNM分期、肿瘤分化、辅助化疗以及c-stage高于p-stage的偏倚均与胃癌患者根治术后OS有关。41例c-stage高于p-stage偏倚的患者的中位OS为37.1个月,低于无偏倚患者的未达到,差异具有统计学意义(P<0.05)。Cox风险比例回归模型显示,T分期以及c-stage高于p-stage的偏倚均是影响根治术后胃癌OS的独立预后因素。结论对于可手术的胃癌病例,c-stage高于p-stage的偏倚提示预后更差,应该作为制定术后辅助治疗方案的依据。 Objective To investigate the effect of preoperative clinical stage(c-stage)on the prognosis of gastric cancer after radical surgery.Methods The clinicopathological data of 134 gastric cancer patients undergoing radical surgery were retrospectively analyzed,of which 41 had c-stage higher than p-stage.The relationship between this bias and the clinicopathological characteristics and total survival(OS)of gastric cancer was analyzed,and the prognostic factors influencing OS of gastric cancer were analyzed by Cox risk proportional regression model.Results The bias of c-stage higher than p-stage was not related to age,gender,tumor site and pathological T stage,but related to pathological N stage,pathological TNM stage and differentiation degree.Univariate analysis showed that postoperative pathological T stage,pathological N stage,TNM stage,tumor differentiation,adjuvant chemotherapy,and c-stage bias higher than p-stage were all associated with OS in gastric cancer patients after radical surgery.The median OS of 41 patients with c-stage bias higher than p-stage bias was 37.1 months,lower than other patients,with statistically significant difference(P<0.05).Cox risk proportional regression model showed that T staging and c-stage higher than p-stage were independent prognostic factors for gastric cancer OS after radical resection.Conclusion For operable gastric cancer cases,the bias of c-stage is higher than p-stage,suggesting a worse prognosis,and should be used as a basis for the formulation of postoperative adjuvant therapy.
作者 王腾 金琳芳 华东 WANG Teng;JIN Linfang;HUA Dong(Department of Medical Oncology,the Affiliated Hospital of Jiangnan University,Wuxi 214062,China)
出处 《临床肿瘤学杂志》 CAS 北大核心 2019年第12期1119-1123,共5页 Chinese Clinical Oncology
基金 江苏省青年医学重点人才资助项目(QNRC2016153) 无锡市卫生计生委精准医学重点专项资助项目(J201807)
关键词 胃癌 临床分期 病理分期 预后 Gastric cancer Preoperative clinical stage Postoperative pathological stage Prognosis
作者简介 通讯作者:华东,E-mail:wx89211@163.com。
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