摘要
目的探讨影响食管胃结合部腺癌患者术后生存率的临床特性。方法回顾性分析2004年1月至2009年12月在我院行手术治疗并获得随访的221例食管胃结合部腺癌患者的临床资料，统计分析患者临床特性及术后化疗对预后的影响。结果全组1、3、5年总的存活率分别为87．3％、57．9％、35．7％。Kaplan—Meier法单因素分析显示，年龄、肿瘤浸润深度、淋巴结转移情况、TNM分期、肿瘤分化程度、Siewert分型及胃壁神经是否受侵犯是影响患者预后的因素。多因素分析显示，分化程度、年龄是影响胃癌术后生存率的独立因素，而通过分析术后化疗对于患者近期生存率时发现，肿瘤分化差、侵及浆膜、有淋巴结转移及胃壁神经受侵犯的患者接受术后化疗3年以上存活率明显高于未接受化疗者。结论肿瘤浸润深度、淋巴结转移率及肿瘤的分化程度是影响食管胃结合部腺癌术后生存的重要因素。而对于肿瘤分化差、侵及浆膜、有淋巴结转移及胃壁神经受侵犯的食管胃结合部腺癌患者，术后化疗可以提高其生存率。
Objective To discuss the clinical characteristics affecting the prognosis of patients with adenocarcinoma of the esophagogastric junction （AEG）after surgery. Methods The clinical data of 221-cases of AEG who underwent surgical treatment at our hospital from January 2004 to December 2009 were retrospectively studied. The clinical characteristics and effects of postoperative chemotherapy on prog- nosis were statistically analyzed. Results The overall survival rates in the first, third and fifth year were 87.3% ,66. 1%, 29.4% respectively. Kaplan-Meier single factor analysis suggested that age, depth of tumor invasion,lymph node metastasis, TNM stage, tumor differentiation, Siewert classification and neural invasion of stomach affected patients prognosis. Multivariate analysis showed that differentiation and age were the independent prognostic factors. In patients with poorly differentiated tumor, serosal invasion,lymph node metastasis or neural invasion, the three - year survival rate of the patients who accepted chemotherapy was significantly higher than that of patients who did not receive chemotherapy. Conclusion Depth of tumor invasion, lymph node metastasis and tumor differentiation are important prognostic factors for gastric cancer patients who undergo gastrectomy. Postoperative chemotherapy could increase the survival rate of gastric carcinoma patients with poorly differentiated tumor, serosal invasion lymph node metastasis or neural
出处
《临床外科杂志》
2013年第1期29-33,共5页
Journal of Clinical Surgery
基金
南京市科技计划项目（编号201106016）
关键词
食管胃结合部腺癌
预后因素
生存率
esophagogastric junction adenocarcinoma
prognostic factor
survival rate
