本文選題：食管胃交界部腺癌　切入點(diǎn)：少數(shù)民族　出處：《寧夏醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探究734例回漢族食管胃交界部腺癌(adenocarcinoma of eso Phagogastric junction,AEG)患者的臨床病理特征及預(yù)后相關(guān)的影響因素。方法選擇2002-01至2012-12于寧夏醫(yī)科大學(xué)總醫(yī)院住院治療,經(jīng)胃鏡和病理確診的734例AEG患者為研究對(duì)象,收集整理包括收集整理患者資料包括性別、年齡、民族、體重指數(shù)、血型、煙酒嗜好、家族史、手術(shù)方式、手術(shù)類型、Siewert分型、Borrmann分型、腫瘤大小、組織學(xué)分型,腫瘤分化、TNM病理分期、淋巴結(jié)清掃數(shù)目、放化療情況、生存狀態(tài)和死亡時(shí)間等指標(biāo);輸入Excel表格,建立數(shù)據(jù)庫(kù)。采用SPSS17.0統(tǒng)計(jì)分析回漢族患者間臨床病理資料及預(yù)后狀況差異是否存在統(tǒng)計(jì)學(xué)意義,并對(duì)AEG預(yù)后相關(guān)因素進(jìn)行單因素、多因素生存分析。結(jié)果(1)734例AEG手術(shù)患者中,回族患者169例,占23.0%,年齡范圍44-78歲,平均年齡61.4±7.4歲;漢族565例,占77.0%,年齡范圍33-86歲,平均年61.1±8.9歲。(2)回漢族間吸煙史分布差異有統(tǒng)計(jì)學(xué)意義(χ~2=43.305,P0.001);回漢族間AEG患者有飲酒史者分布差異有統(tǒng)計(jì)學(xué)意義(χ~2=49.612,P0.001)。回漢族AEG患者間手術(shù)方式、手術(shù)類型、Siewert分型、Bormann分型差異無(wú)統(tǒng)計(jì)學(xué)意義(χ~2=2.797,P=0.424;χ~2=0.290,P=0.865;χ~2=3.945,P=0.267);回漢族AEG患者間組織學(xué)類型、分化程度、TNM分期分布差異無(wú)統(tǒng)計(jì)學(xué)意義(χ~2=2.714,P=0.257;χ~2=3.911,P=0.141;χ~2=1.697,P=0.638);回漢族AEG患者間行輔助治療者分布差異無(wú)統(tǒng)計(jì)學(xué)意義(χ~2=1.725,P=0.189)。(3)265例隨訪AEG患者(36.1%),回族AEG術(shù)后患者,平均隨訪時(shí)間為38.4個(gè)月,5年總生存率是54.3%;漢族AEG術(shù)后患者,平均隨訪時(shí)間為46.4個(gè)月;5年總生存率是39.9%。單因素分析顯示:年齡、性別、飲酒史、手術(shù)類型、Bormann分型、腫瘤大小、腫瘤分化、病理T分期、N分期、M分期等因素(P0.05)是影響AEG預(yù)后的主要因素。多因素分析顯示:年齡(p=0.005)、性別(p=0.015)、病理T分期(p=0.056),N分期(p0.001),M分期(p0.001),清掃淋巴結(jié)數(shù)目(p=0.003),輔助放化療(p=0.005)是影響AEG預(yù)后的獨(dú)立危險(xiǎn)因素。結(jié)論(1)回漢族AEG患者皆好發(fā)于老年男性、有吸煙飲酒史者,病理類型以低分化腺癌多見(jiàn),TNM分期IV期多見(jiàn)。(2)回族患者中吸煙、飲酒人數(shù)明顯少于漢族患者,合理健康的生活方式以及早診早治是預(yù)防AEG發(fā)生以及改善預(yù)后的有效途徑。(3)AEG的預(yù)后較差,年齡、性別、病理T分期、N分期、M分期、清掃淋巴結(jié)數(shù)目、輔助放化療,7個(gè)因素是影響AEG預(yù)后的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective to investigate the clinicopathological characteristics and prognostic factors of 734 patients with adenocarcinoma of eso Phagogastric junctions (AEGG) in the esophagogastric junction of Han nationality. Methods from January 2002 to December 2012, the patients were hospitalized in the General Hospital of Ningxia Medical University. A total of 734 patients with AEG diagnosed by gastroscopy and pathology were included in the study. Data of the patients were collected, including sex, age, nationality, body mass index, blood type, tobacco and alcohol addiction, family history, operation methods. Siewert type: Borrmann classification, tumor size, histological classification, pathological stage of tumor differentiation, number of lymph nodes dissection, radiotherapy and chemotherapy, survival status and time of death, etc. To establish the database. To analyze the difference of clinicopathological data and prognosis status between Han nationality patients by SPSS17.0 statistics, and to analyze the prognostic factors of AEG by single factor and multivariate survival analysis. Results in 734 patients with AEG operation, there were 734 cases of AEG operation. There were 169 Hui patients, accounting for 23.0%, with an average age of 61.4 鹵7.4 years, 44-78 years old, 565 cases of Han nationality (77.0%), 33-86 years old, 565 cases of Han nationality. The average age was 61.1 鹵8.9 years old. The distribution of smoking history in Hui Han nationality was significantly different (蠂 ~ 2 ~ 2 ~ (2) 3. 305) P 0.001 ~ (-1), and the distribution of AEG patients with drinking history was significant (蠂 ~ (2) ~ (2) ~ (2) ~ (29) ~ (12) P _ (0.001) P ~ (0.001)). There was a significant difference in operation mode among AEG patients in Hui Han nationality. There was no significant difference in the type of operation between the two groups (蠂 ~ 2 / 2 / 2.797 / P ~ (0.424); 蠂 ~ (2 / 2) = 0.290 / P ~ (0.865)); 蠂 ~ (2 +) = 3.945 / P ~ (0.267); the histological types of patients with AEG in Han nationality were as follows:. There was no significant difference in the distribution of TNM stages (蠂 ~ 2 / 2 / 2.714 / P ~ (0.257); 蠂 ~ (2 / 2) = 3.911 / P ~ (0.141)); 蠂 ~ (2 +) = 1.697 / P ~ (0.638); there was no significant difference in the distribution of patients receiving adjuvant therapy among the patients with AEG in Han nationality (蠂 ~ (21) 725 P ~ (0.189)). 3265 cases of AEG patients were followed up after AEG operation, and there was no significant difference between them (蠂 ~ (21.725) P _ (0.189)). The average follow-up time was 38.4 months, the 5-year overall survival rate was 54.3, the average follow-up time was 46.4 months in the Han patients after AEG, and the 5-year overall survival rate was 39.9. Univariate analysis showed: age, sex, history of drinking, type of operation, Bormann classification, tumor size. Tumor differentiation, Multivariate analysis showed that age and age were 0.005, sex was 0.015, pathological T stage was p0.0056 / M stage, lymph node number was p0.003, adjuvant radiotherapy and chemotherapy were associated with P0.001, p0.001, p0.001, p0.003, and p0.005) were the main factors influencing the prognosis of AEG. The results of multivariate analysis showed that age was 0.005%, sex was 0.015%, pathological T stage was p0.001 / M stage, lymph node number was p0.003%, and adjuvant radiotherapy and chemotherapy were associated with P0.005). Conclusion the patients with AEG in Han nationality are more likely to occur in elderly men. Among the patients with smoking and drinking history, low differentiated adenocarcinoma was the most common type. TNM stage IV was more common in Hui nationality patients, and the number of drinkers was significantly lower than that of Han nationality patients. A reasonable and healthy lifestyle and early diagnosis and treatment were effective ways to prevent AEG and improve prognosis. The prognosis of AEG was poor. Age, sex, pathological T stage, N stage and M stage, number of lymph nodes dissected. In adjuvant radiotherapy and chemotherapy, 7 factors were independent risk factors for the prognosis of AEG.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R735
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本文編號(hào)：1600622