本文選題：胃癌 + 病理　； 參考：《延邊大學》2015年碩士論文

【摘要】：目的探討胃癌(GC)患者病理分型、腫瘤直徑、轉(zhuǎn)移、分期、GC后發(fā)生貧血間的相關(guān)性及影響預后因素。方法收集延邊醫(yī)院2004年1月至2013年12月10年間以GC為診斷在延邊大學附屬醫(yī)院住院患者共1249例進行回顧性分析,其中病理資料完整者905例。計數(shù)資料差異性分析采用X2檢驗,等級資料采用秩和檢驗,計量資料采用方差分析和t檢驗,計數(shù)資料趨勢檢驗采用X2檢驗,計量資料趨勢檢驗采用方差分析,影響GC預后因素采用logistic回歸分析；統(tǒng)計學分析采用SPSS 19.0統(tǒng)計軟件,p0.05為差異有統(tǒng)計學意義結(jié)果1.2004年1月至2013年12月GC患者1249例,其中男924例,女325例,男女比例為2.84：1。2.GC患者年齡最小24歲,最大90歲,平均年齡61.40±10.61歲。依年齡特點可將GC分為三個階段,即≤40歲、4 1至60歲及60歲,其中≤40歲GC患者前5年(2004-2008年)24例(4.48%),近5年(2009-2013年)19例(2.66%),4 1至60歲前5年237例(44.22%),近5年268例(37.59%),60歲前5年275例(51.30%),近5年426例(59.75%),近5年較前5年比較,GC患者年齡分布趨向老年人。3.905例病理完整的GC患者中高分化癌57例(6.3%),中分化癌276例(30.5%),低分化癌566例(62.5%),其他(分化程度不清楚)6例(0.7%),以低分化癌最多見；GC發(fā)生轉(zhuǎn)移情況為,無轉(zhuǎn)移253(28.0%)例,有淋巴轉(zhuǎn)移322(35.6%)例,有周圍臟器轉(zhuǎn)移166(18.3%)例,遠處轉(zhuǎn)移164(18.1%)例,以淋巴轉(zhuǎn)移最多見。高分化癌發(fā)生轉(zhuǎn)移13例,轉(zhuǎn)移率22.8%；中分化癌發(fā)生轉(zhuǎn)移184例,轉(zhuǎn)移率66.7%；低分化癌發(fā)生轉(zhuǎn)移449例,轉(zhuǎn)移率79.3%。分化程度越低,轉(zhuǎn)移率越高。無轉(zhuǎn)移的GC患者253例,直徑3.11±1.90cm,淋巴轉(zhuǎn)移的GC患者322例,直徑4.04±1.73cm,臟器轉(zhuǎn)移GC患者166例,直徑4.58±1.94cm,遠處轉(zhuǎn)移GC患者164例,直徑4.59±2.08 cm。直徑越大,發(fā)生轉(zhuǎn)移越遠。4.高分化癌發(fā)生貧血21例,貧血發(fā)生率36.8%,中分化癌發(fā)生貧血147例,貧血發(fā)生率53.3%,低分化癌發(fā)生貧血250例,貧血發(fā)生率44.2%。GC患者發(fā)生貧血程度與腫瘤分化程度間差異無統(tǒng)計學意義,但是,有無貧血與腫瘤分化程度有關(guān)。Ⅰ、Ⅱ期GC患者504例,發(fā)生貧血190例,貧血發(fā)生率37.7%,Ⅲ、 Ⅳ期GC患者401例,發(fā)生貧血231例,貧血發(fā)生率57.6%,Ⅲ、Ⅳ期GC患者貧血發(fā)生率高于Ⅰ、Ⅱ期。GC患者無轉(zhuǎn)移253例,發(fā)生貧血86例,貧血發(fā)生率34.0%；淋巴轉(zhuǎn)移322例,發(fā)生貧血142例,貧血發(fā)生率44.1%；臟器轉(zhuǎn)移166例,發(fā)生貧血壓97例,貧血發(fā)生率58.4%,遠處轉(zhuǎn)移164例,發(fā)生貧血96例,貧血發(fā)生率58.5%。轉(zhuǎn)移越遠,貧血L發(fā)生率越高。5.至今為止,905例GC患者未愈死亡161例,病情好轉(zhuǎn)患者744例。單因素分析發(fā)現(xiàn),民族、Hb值、腫瘤分化程度、轉(zhuǎn)移情況、治療方式、病理分期、直徑大小是影響GC的相關(guān)因素,年齡、性別、吸煙、飲酒、肝炎不是GC預后影響因素。多因素分析發(fā)現(xiàn)民族、Hb值、轉(zhuǎn)移情況、治療方式是影響GC預后的獨立影響因素,其中朝鮮族、Hb異常、臟器和遠處轉(zhuǎn)移是危險因素；手術(shù)治療手術(shù)+輔助治療是保護因素。結(jié)論1.近5年GC患者年齡分布趨向于老齡化。2.GC患者腫瘤分化程度越低發(fā)生轉(zhuǎn)移率越高；腫瘤直徑越大,發(fā)生轉(zhuǎn)移越遠。3.GC患者發(fā)生轉(zhuǎn)移越遠,貧血發(fā)生率越高；Ⅲ、Ⅳ期GC患者貧血發(fā)生率高于Ⅰ、Ⅱ期。4.民族、Hb值、腫瘤分化程度、轉(zhuǎn)移情況、治療方式、病理分期、直徑大小是GC患者預后的相關(guān)因素。5.朝鮮族、發(fā)生貧血、發(fā)生臟器和遠處轉(zhuǎn)移的GC患者預后差,經(jīng)手術(shù)治療和手術(shù)+輔助治療的GC患者預后相對好。
[Abstract]:Objective to investigate the pathological classification of patients with gastric cancer (GC), tumor diameter, metastasis, staging, anemia and prognostic factors after GC. Methods a total of 1249 cases of hospitalized patients in Affiliated Hospital of Yanbian University from January 2004 to December 2013 were retrospectively analyzed in Yanbian hospital, including 905 cases with complete pathological data. The difference analysis of counting data was analyzed by X2 test, rank data used rank sum test, measurement data using variance analysis and t test, counting data trend test using X2 test, measurement data trend test using variance analysis, influencing factors of GC prognosis by logistic regression analysis, statistical analysis using SPSS 19 statistical software, P0.05 is poor. There were 1249 cases of GC in 1.2004 years from January to December 2013, including 924 males and 325 females. The age of male and female was 24 years old, the maximum was 90 years, and the average age was 61.40 + 10.61 years. GC could be divided into three stages according to the age characteristics, that is, less than 40 years, 41 to 60 and 60 years. 008 years (4.48%), nearly 5 years (2009-2013 years) 19 cases (2.66%), 41 to 60 years before 5 years 237 cases (44.22%), nearly 5 years before the year, compared with the previous year, the age distribution of GC patients tend to.3.905 cases of GC patients with highly differentiated carcinoma. 566 cases (62.5%) of low differentiated carcinoma (62.5%) and 6 cases (0.7%) with low differentiation, GC metastasis, 253 (28%) without metastasis, 322 (35.6%) with lymphatic metastasis, 166 (18.3%) with metastasis of peripheral organs, 164 metastasis of distant metastasis (18.1%), most of metastatic carcinoma, metastasis 13, metastasis rate. .8%; metastasize in 184 cases, the metastasis rate was 66.7%, the metastasis rate of low differentiated carcinoma was 449, the metastasis rate of 79.3%. was lower, the metastasis rate was higher, 253 cases of non metastatic GC patients, 3.11 + 1.90cm in diameter, 322 of GC in lymphatic metastasis, 4.04 in diameter, 166 in GC patients, 4.58 in diameter, and 164 in distant metastasis GC patients 164 For example, the larger the diameter of 4.59 + 2.08 cm., 21 cases of anaemia occurred in.4. highly differentiated carcinoma, 36.8% of anemia, 147 cases of anaemia in medium differentiated carcinoma, 53.3% of anemia, 250 cases of anemia in low differentiated carcinoma, and there was no statistical difference between anemia and tumor differentiation in 44.2%.GC patients, but there were no statistical significance. No anemia was associated with the degree of tumor differentiation. 504 patients with phase II GC, anemia occurred in 190 cases, anemia occurred in 37.7%, III, IV GC patients, anemia in 231 cases, anemia in 231 cases, anemia in 57.6%, III, IV GC patients were higher than I, no metastasis in stage.GC patients 253 cases, anemia 86 cases, anemia 34%, 322 lymph node metastasis, 322 lymphatic metastasis, 322 Anaemia occurred in 142 cases, anemia incidence was 44.1%, organ metastasis 166 cases, anemia 97 cases, anemia incidence 58.4%, distant metastasis 164 cases, anemia 96 cases, anemia incidence of 58.5%. metastasis, the higher the incidence of anemia L, the higher.5. so far, 905 cases of GC patients, 161 cases, 744 cases. Single factor analysis found, people analysis, people found, people, people analysis, people analysis, people found, people, people, factors analysis found, people, people, people. Family, Hb, tumor differentiation, metastasis, treatment, pathological stage, and diameter are related factors affecting GC, age, sex, smoking, drinking, and hepatitis are not the prognostic factors of GC. Multifactor analysis found that ethnic, Hb, metastasis, and treatment are independent factors affecting the prognosis of GC, including the Korean, Hb abnormality, and organs. And distant metastasis is a risk factor; surgical operation plus adjuvant therapy is a protective factor. Conclusion the age distribution of GC patients in the last 5 years of GC tends to be higher in the aging.2.GC patients, the higher the tumor differentiation degree, the greater the diameter of the tumor, the farther the metastasis is, the farther the.3.GC is, the higher the incidence of anemia; III, IV GC patients The incidence of anemia was higher than that of I..4. nationality, Hb value, degree of differentiation, metastasis, treatment, pathological stage, diameter were related factors of prognosis in GC patients.5. Korean nationality, anemia, and poor prognosis of GC patients with visceral and distant metastasis, and the prognosis of GC patients with surgical treatment and adjuvant therapy was relatively good.
【學位授予單位】：延邊大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R735.2

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本文編號：2089030