摘要
目的比较胃癌BorrmannⅣ型与其他Borrmann分型，了解BorrmannⅣ型胃癌的临床病理特点及影响预后的因素。方法回顾性分析893例连续的进展期胃癌手术患者，比较139例BorrmannⅣ型（15．6％）和754例其他Borrmann分型（84．4％）的胃癌患者临床病理特点及其预后。结果与其他Borrmann分型相比，BorrmannⅣ型胃癌诊断时多处于晚期，临床病理特征均较差。BorrmannⅣ型胃癌有较高的术前活检阴性率（15．9％），明显高于其他Borrmann分型的胃癌患者。BorrmannⅣ型的5年生存率为9．9％，明显低于其他Borrmann分型，差异具有显著的统计学意义。根治术后患者5年总体生存率为18．7％，明显高于未接受根治手术的患者。TNM分期分层分析显示TNMⅡ、Ⅲ期时，BorrmannⅣ型显示更差的预后（P〈0．05）。多因素分析结果显示远处转移和根治手术是BorrmannⅣ型胃癌患者的独立预后因素。结论与其他Borrmann类型的相比，BorrmannⅣ型胃癌患者的临床病理特征及预后均较差，早期诊断及接受根治手术有助于改善预后。
Objective To compare Borrmann type Ⅳ gastric cancer with other types of cancer and explore their clinicopathological features and prognostic factors. Methods We retrospectively reviewed the medical records of 893 consecutive advanced gastric cancer patients. They were divided into 2 groups： Borrmann type IV （ n = 139 ） and other macroscopic Borrmann types of cancer （ n = 754 ） . Their clinicopathologic characteristics and overall survival data were analyzed. Results Borrmann type Ⅳ gastric cancer was found to be associated with more advanced and unfavorable clinicopathological features. The incidence of preoperative biopsy-negative rate of Borrmann type Ⅳ gastric cancer was much higher （ 15.9% ） than other Borrmann types of gastric cancer. The 5-year survival rate of Borrmann type IV cancer patients was 9. 9% and it was significantly lower than that of other types. Moreover, the 5-year survival rate was higher in the patients with curative resection （18.7%） （P 〈 0. 05 ）. Stratified analysis revealed that when the tumor TNM stages were of Ⅱ , Ⅲ, the survival data of Borrmann type Ⅳ cancer were worse than others. Multivariate analyses revealed distant metastasis and curability were independent prognostic factors for Borrmann type Ⅳ gastric cancer. Conclusions Borrmann type Ⅳ carcinoma has poor clinicopathological features and survival rate compared with other types. An early detection and curative resection may improve the prognosis for the patients with Borrmann type Ⅳ cancer.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第36期2534-2537,共4页
National Medical Journal of China
基金
广东省科技计划项目（20108031600223,201117,031800271）
