發(fā)布時(shí)間：2018-03-15 11:40

  本文選題：胃癌　切入點(diǎn)：神經(jīng)侵犯　出處：《南昌大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:回顧性分析Ib-IIIc期胃癌根治性術(shù)后患者的臨床病例及回訪資料,探討胃癌術(shù)后預(yù)后因素及神經(jīng)脈管侵犯對(duì)胃癌預(yù)后的影響。方法:收集2009年1月至2010年4月在南昌大學(xué)第一附屬醫(yī)院腫瘤科收治的Ib-IIIc期胃癌根治術(shù)后患者,所有患者均行胃癌根治術(shù),術(shù)后行6-8周期的輔助化療,部分患者行術(shù)后輔助放療。隨訪及病例分析內(nèi)容包括:性別、年齡、神經(jīng)侵犯、脈管侵犯、分化程度、Lauren分型、浸潤(rùn)深度、淋巴結(jié)轉(zhuǎn)移、是否放療,采用Kaplan-Meier法計(jì)算生存率,單因素分析應(yīng)用Log-rank檢驗(yàn)比較各因素對(duì)患者預(yù)后的影響,采用COX風(fēng)險(xiǎn)比率模型進(jìn)行多因素回歸分析。P0.05為有統(tǒng)計(jì)學(xué)差異。結(jié)果:1、采用Log-rank檢驗(yàn)進(jìn)行單因素分析,結(jié)果顯示:神經(jīng)侵犯、脈管侵犯、分化程度、Lauren分型、浸潤(rùn)深度、淋巴結(jié)轉(zhuǎn)移、是否放療對(duì)Ib-IIIc期胃癌根治術(shù)后患者的預(yù)后影響有統(tǒng)計(jì)學(xué)差異;而性別、年齡對(duì)預(yù)后的影響無(wú)統(tǒng)計(jì)學(xué)差異;2、將上述單因素分析中有統(tǒng)計(jì)學(xué)差異的因素納入Cox風(fēng)險(xiǎn)比率模型進(jìn)行多因素回歸分析,結(jié)果顯示:神經(jīng)侵犯、脈管侵犯、分化程度、浸潤(rùn)深度、淋巴結(jié)轉(zhuǎn)移是影響Ib-IIIc期胃癌根治術(shù)后患者預(yù)后的獨(dú)立因素。結(jié)論:神經(jīng)侵犯、脈管侵犯、分化程度低、彌漫型、腫瘤浸潤(rùn)深度、淋巴結(jié)轉(zhuǎn)移、未行放療為Ib-IIIc期胃癌根治術(shù)后患者的預(yù)后不良因素。其中神經(jīng)侵犯、脈管侵犯、分化程度、浸潤(rùn)深度、淋巴結(jié)轉(zhuǎn)移為Ib-IIIc期胃癌根治術(shù)后患者的獨(dú)立預(yù)后因素。
[Abstract]:Objective: to retrospectively analyze the clinical cases and data of patients with Ib-IIIc stage gastric cancer after radical operation. To investigate the prognostic factors after operation of gastric cancer and the influence of neurovascular invasion on the prognosis of gastric cancer methods: from January 2009 to April 2010, we collected the patients treated in the Department of Oncology of the first affiliated Hospital of Nanchang University after radical gastrectomy for gastric cancer. All patients underwent radical gastrectomy, followed by 6 to 8 cycles of adjuvant chemotherapy, and some patients received postoperative adjuvant radiotherapy. The follow-up and case analysis included gender, age, nerve invasion, vascular invasion, degree of differentiation, Lauren classification, depth of infiltration. Lymph node metastasis, radiotherapy or not, Kaplan-Meier method was used to calculate the survival rate. Univariate analysis was used to compare the influence of various factors on the prognosis of the patients by Log-rank test. COX risk ratio model was used for multivariate regression analysis. Results: 1. Result: 1. Log-rank test was used for univariate analysis. The results showed that: neural invasion, vascular invasion, differentiation degree, depth of invasion, lymph node metastasis. The effect of radiotherapy on the prognosis of patients with Ib-IIIc gastric cancer after radical resection was statistically different. There was no significant difference in the influence of age on prognosis. The factors with statistical difference in univariate analysis mentioned above were included in the Cox risk ratio model for multivariate regression analysis. The results showed that: nerve invasion, vascular invasion, differentiation, depth of invasion. Lymph node metastasis is an independent factor influencing the prognosis of patients with gastric cancer after radical operation in Ib-IIIc stage. Conclusion: nerve invasion, vascular invasion, low differentiation, diffuse type, depth of tumor invasion, lymph node metastasis. No radiotherapy was used as a poor prognostic factor in patients with gastric cancer after radical operation in Ib-IIIc stage, in which nerve invasion, vascular invasion, differentiation, depth of invasion, lymph node metastasis were independent prognostic factors after radical operation of gastric cancer in Ib-IIIc stage.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R735.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 黃天臣;肖建安;王清兵;王雁軍;張勇;白東曉;邱新光;;胃癌神經(jīng)侵犯與預(yù)后的相關(guān)性分析[J];中外醫(yī)療;2013年24期

2 ;Impact of lymphatic and/or blood vessel invasion in stage Ⅱ gastric cancer[J];World Journal of Gastroenterology;2012年27期

3 高永根;尹軍;;胃癌手術(shù)患者預(yù)后影響因素分析[J];實(shí)用預(yù)防醫(yī)學(xué);2011年08期

4 于穎彥;;胃癌的病理分型與預(yù)后[J];外科理論與實(shí)踐;2011年03期

5 柳珂;于觀貞;陳穎;羅天行;王喜;潘軍;王杰軍;;青年與老年胃癌的臨床特征與預(yù)后分析[J];臨床腫瘤學(xué)雜志;2011年03期

6 ;Prognosis of 980 patients with gastric cancer after surgical resection[J];癌癥;2010年11期

7 馬海波;王爽;魏克飛;孫小梁;;胃癌根治術(shù)后生存狀態(tài)的5年隨訪[J];世界華人消化雜志;2010年27期

8 Alberto Biondi;Roberto Persiani;Ferdinando Cananzi;Marco Zoccali;Vincenzo Vigorita;Andrea Tufo;Domenico D'Ugo;;R0 resection in the treatment of gastric cancer:Room for improvement[J];World Journal of Gastroenterology;2010年27期

9 夏研;徐紅;孫巖;張建廣;王麗波;;幽門(mén)螺旋桿菌感染與胃癌中CDK1表達(dá)的關(guān)系[J];中國(guó)實(shí)用內(nèi)科雜志;2010年03期

10 高志軍;趙春臨;喬軍波;張謝夫;;HSP90抑制劑17-DMAG對(duì)胃癌細(xì)胞株SGC-7901增殖及凋亡的影響[J];世界華人消化雜志;2008年29期

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