發(fā)布時間：2018-06-09 03:22

  本文選題：胃癌 + 臨床病理特征�。� 參考：《第四軍醫(yī)大學(xué)》2016年碩士論文

【摘要】：目的1.探討ABO血型與胃癌患者臨床病理特征及預(yù)后的關(guān)系;2.評估不同腫瘤標(biāo)志物水平的四種ABO血型胃癌患者的預(yù)后差異;3.評估術(shù)前血清CEA對四種ABO血型胃癌患者的預(yù)后指導(dǎo)價值。方法1.回顧性收集2008年6月至2013年10月間第四軍醫(yī)大學(xué)第一附屬西京醫(yī)院消化外科診斷為胃癌并接受根治性手術(shù)治療的2838例患者的臨床及隨訪資料,分析血型分布與胃癌患者臨床病理特征的相關(guān)性,并比較不同血型胃癌患者的預(yù)后差異。2.回顧性收集我院消化外科2008年6月至2015年4月接受根治性手術(shù)治療且術(shù)前檢測血清腫瘤標(biāo)志物的3307例胃癌患者的臨床及隨訪資料,以四種術(shù)前血清腫瘤標(biāo)志物水平為分層,比較各分層不同血型之間的預(yù)后差異。3.在第二部分基礎(chǔ)上,篩選有術(shù)前血清CEA檢測的我院消化外科2008年6月至2015年4月間的3297例胃癌患者的臨床及隨訪資料。評估術(shù)前血清CEA水平在不同ABO血型胃癌患者中的預(yù)后指導(dǎo)作用。結(jié)果1.ABO血型分布與胃癌患者的臨床病理特征沒有顯著關(guān)聯(lián)(均P0.05),A,B,O,AB血型胃癌患者的5年總體生存率分別為57.3%,54.7%,57.4%,53.5%。不同血型的胃癌患者總體生存率差異沒有統(tǒng)計(jì)學(xué)意義(P=0.722),然而在AJCCⅢ期或有吸煙史的胃癌患者中,非AB血型(A,B,O)胃癌患者的總體生存率顯著低于AB血型胃癌患者(Ⅲ期44.7%比25.2%,P=0.014;吸煙史:74.9%比53.4%,P=0.044)。2.不同腫瘤標(biāo)志物水平的四種血型患者預(yù)后差異沒有統(tǒng)計(jì)學(xué)意義(均P0.05),然而在660例術(shù)前血清CEA陽性的胃癌患者中,AB血型患者生存時間顯著高于非AB血型患者(P=0.014),中位生存期分別為58.2月和25.2月,5年總體生存率為45.8%和35.4%。多因素生存分析顯示:對于CEA陽性的胃癌患者,AB血型是其有利且獨(dú)立的預(yù)后影響因素。3.在總體胃癌患者預(yù)后影響的多因素生存分析中,術(shù)前血清CEA是預(yù)后的獨(dú)立危險因素(P0.001),分別在A型血、B型血、O型血胃癌患者的多因素生存分析中,CEA均是其預(yù)后的獨(dú)立危險因素(均P0.001),然而對于AB血型胃癌患者,單因素和多因素生存分析提示CEA不是影響預(yù)后的獨(dú)立危險因素(P=0.189,P=0.956)。在總體中,CEA陰性和CEA陽性患者的5年總體生存率分別為61.3%和36.3%,在A型血患者中分別為61.7%和33.5%,在B型血中分別為61.3%和38.9%;在O型血中為62.4%和32.2%(均P0.001),在AB血型中分別為57.9%和45.8%(P=0.189)。結(jié)論1.ABO血型分布與胃癌患者的臨床病理特征無明顯關(guān)聯(lián),對于總體而言,血型不是胃癌患者的獨(dú)立預(yù)后因素,但在Ⅲ期患者以及有吸煙史的患者中,AB血型可提示更好的預(yù)后。2.對于術(shù)前血清CEA陽性的胃癌患者而言,AB血型可提示更好的預(yù)后。3.對于非AB血型(A,B和O)胃癌患者,術(shù)前CEA是影響其預(yù)后的獨(dú)立危險因素,然而對于AB血型胃癌患者,CEA并不是影響預(yù)后的獨(dú)立危險因素。
[Abstract]:Objective 1. To investigate the relationship between ABO blood group and clinicopathological features and prognosis of gastric cancer. The prognosis of four ABO blood group gastric cancer patients with different tumor markers was 3. 3%. To evaluate the prognostic value of preoperative serum CEA in patients with gastric cancer with four ABO blood groups. Method 1. From June 2008 to October 2013, the clinical and follow-up data of 2838 patients with gastric cancer diagnosed by digestive surgery in Xijing Hospital affiliated to the fourth military Medical University were retrospectively collected. To analyze the relationship between blood group distribution and clinicopathological features of gastric cancer patients, and to compare the prognostic difference of gastric cancer patients with different blood groups. The clinical and follow-up data of 3307 patients with gastric cancer who underwent radical surgery from June 2008 to April 2015 were retrospectively collected. Compare the prognostic differences between different blood groups. 3. 3. On the basis of the second part, the clinical and follow-up data of 3297 patients with gastric cancer from June 2008 to April 2015 were selected. To evaluate the prognostic value of preoperative serum CEA level in patients with gastric cancer with different ABO blood groups. Results 1. There was no significant correlation between ABO blood group distribution and clinicopathological features of gastric cancer patients (P 0.05). The 5-year overall survival rates of patients with gastric cancer were 57.3% and 54.7%, respectively. There was no significant difference in overall survival rate among patients with different blood types of gastric cancer. However, in patients with AJCC 鈪，

本文編號：1998634