【摘要】：目的通過CT診斷,分析胃癌根治術(shù)后復(fù)發(fā)與轉(zhuǎn)移的區(qū)域及規(guī)律。方法選取2009年6月至2014年6月胃癌患者共81例,均行胃癌根治性手術(shù),隨訪期間CT發(fā)現(xiàn)存在局部區(qū)域復(fù)發(fā)或轉(zhuǎn)移。分析術(shù)后復(fù)發(fā)與轉(zhuǎn)移的區(qū)域及規(guī)律。用SPSS 19.0軟件分析數(shù)據(jù),以%表示計(jì)數(shù)資料,Logistic回歸分析檢驗(yàn)術(shù)后復(fù)發(fā)時(shí)間和臨床病理特征和治療之間的關(guān)系;P0.05,差異具有統(tǒng)計(jì)學(xué)意義。結(jié)果在81例術(shù)后復(fù)發(fā)患者中,局部區(qū)域復(fù)發(fā)率最高(37.04%),在18例伴有術(shù)后區(qū)域淋巴結(jié)轉(zhuǎn)移的患者中,Ⅰ區(qū)10例,Ⅲ區(qū)3例,Ⅳ區(qū)1例,Ⅵ區(qū)4例。術(shù)后7~12個(gè)月復(fù)發(fā)率最高(41.98%)。截止至2015年9月30日,在胃癌根治術(shù)后復(fù)發(fā)的81例患者中,中位總生存時(shí)間(OS)為33.18個(gè)月,中位復(fù)發(fā)時(shí)間為19.94個(gè)月,復(fù)發(fā)后中位生存期為7.19個(gè)月。其中發(fā)生腹膜種植后,中位生存期最短,僅為4.24個(gè)月。單因素分析結(jié)果顯示,與OS相關(guān)的臨床病理因素包括年齡(P=0.024),Borrmann分型(P=0.017)、TNM分期(P=0.009)、淋巴結(jié)檢出總數(shù)(P=0.022)、陽(yáng)性淋巴結(jié)數(shù)(P=0.002)、治療方式(P=0.026)和治療依從性(P=0.035);與局部無復(fù)發(fā)生存期(LRFS)相關(guān)的臨床病理因素包括淋巴結(jié)檢出總數(shù)(P=0.012)、陽(yáng)性淋巴結(jié)數(shù)(P=0.008)、治療方式(P=0.034)和治療依從性(P=0.016)。結(jié)論局部區(qū)域復(fù)發(fā),特別是區(qū)域淋巴結(jié)轉(zhuǎn)移是胃癌根治術(shù)后復(fù)發(fā)的主要形式,術(shù)后通過CT劃分淋巴結(jié)轉(zhuǎn)移區(qū)域?qū)τ诜暖煱袇^(qū)確定具有一定指導(dǎo)意義。
[Abstract]:Objective to analyze the region and regularity of recurrence and metastasis of gastric cancer after radical resection by CT. Methods from June 2009 to June 2014, 81 patients with gastric cancer underwent radical operation. CT found local recurrence or metastasis during follow-up. The region and regularity of recurrence and metastasis after operation were analyzed. The data were analyzed by SPSS 19.0 software, and the counting data were expressed in%. Logistic regression analysis was used to test the relationship between postoperative recurrence time and clinicopathological features and treatment, and P0.05, the difference was statistically significant. Results among 81 patients with postoperative recurrence, the local recurrence rate was the highest (37.04%). Among 18 patients with regional lymph node metastasis, there were 10 cases in area 鈪，

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