發(fā)布時間：2018-04-04 11:43

  本文選題：胃癌　切入點：肝轉(zhuǎn)移　出處：《醫(yī)學(xué)研究生學(xué)報》2017年02期

【摘要】：目的肝是胃癌轉(zhuǎn)移的常見部位,但目前對于出現(xiàn)肝轉(zhuǎn)移的胃癌患者尚無統(tǒng)一治療規(guī)范。文中探討胃癌肝轉(zhuǎn)移患者的臨床特征和預(yù)后因素,為提高胃癌肝轉(zhuǎn)移患者診治水平提供依據(jù)。方法對四川省人民醫(yī)院2009年1月至2014年6月收治的143例胃癌肝轉(zhuǎn)移患者的臨床特征及生存資料進行回顧性分析,采用Cox回歸模型探討影響患者預(yù)后的獨立危險因素。結(jié)果 143例胃癌肝轉(zhuǎn)移患者中位生存期為14個月,1、2、3年生存率依次為52.4%、28.7%、12.6%。單因素分析顯示,不同原發(fā)胃癌組織學(xué)分級、肝轉(zhuǎn)移時間、肝轉(zhuǎn)移癌類型、肝外轉(zhuǎn)移情況和治療方式的胃癌肝轉(zhuǎn)移患者間的生存狀況差異有統(tǒng)計學(xué)意義(P0.05)。多元Cox回歸分析顯示,胃癌組織學(xué)分級為低分化或未分化(HR=2.67,95%CI:1.51~4.72)、肝轉(zhuǎn)移癌類型為H2(HR=1.89,95%CI:1.08~3.29)或H3(HR=2.13,95%CI:1.32~3.44)為胃癌肝轉(zhuǎn)移患者預(yù)后的獨立危險因素;姑息化療(HR=0.55,95%CI:0.32~0.95)為胃癌肝轉(zhuǎn)移患者預(yù)后的獨立保護因素。結(jié)論胃癌肝轉(zhuǎn)移患者預(yù)后較差。胃癌組織學(xué)分級低、肝轉(zhuǎn)移癌類型為H2或H3的胃癌肝轉(zhuǎn)移患者預(yù)后相對較差。接受姑息化療的胃癌肝轉(zhuǎn)移患者預(yù)后好于接受最佳支持治療的患者,因此臨床上應(yīng)盡量考慮為使患者提供綜合治療機會。
[Abstract]:Objective liver is a common site of gastric cancer metastasis, but there is no unified treatment standard for gastric cancer patients with liver metastasis.The clinical features and prognostic factors of patients with liver metastasis of gastric cancer were discussed in order to provide evidence for improving the diagnosis and treatment of patients with liver metastasis of gastric cancer.Methods the clinical features and survival data of 143 patients with hepatic metastasis of gastric cancer admitted to Sichuan Provincial people's Hospital from January 2009 to June 2014 were retrospectively analyzed. The independent risk factors affecting the prognosis of patients were investigated by Cox regression model.Results the median survival time of 143 patients with hepatic metastasis of gastric cancer was 14 months / 2, and the 3-year survival rate was 52.4 / 28.7 / 12.6 respectively.Univariate analysis showed that there were significant differences in survival status among patients with different primary gastric cancer histological grade, liver metastasis time, liver metastasis type, extrahepatic metastasis and treatment.澶氬厓Cox鍥炲綊鍒嗘瀽鏄劇ず,鑳冪檶緇勭粐瀛﹀垎綰т負(fù)浣庡垎鍖栨垨鏈垎鍖，

本文編號：1709817