神经脉管侵犯与胃癌的预后因素研究

发布时间：2018-03-15 11:40

本文选题：胃癌　切入点：神经侵犯　出处：《南昌大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:回顾性分析Ib-IIIc期胃癌根治性术后患者的临床病例及回访资料,探讨胃癌术后预后因素及神经脉管侵犯对胃癌预后的影响。方法:收集2009年1月至2010年4月在南昌大学第一附属医院肿瘤科收治的Ib-IIIc期胃癌根治术后患者,所有患者均行胃癌根治术,术后行6-8周期的辅助化疗,部分患者行术后辅助放疗。随访及病例分析内容包括:性别、年龄、神经侵犯、脉管侵犯、分化程度、Lauren分型、浸润深度、淋巴结转移、是否放疗,采用Kaplan-Meier法计算生存率,单因素分析应用Log-rank检验比较各因素对患者预后的影响,采用COX风险比率模型进行多因素回归分析。P0.05为有统计学差异。结果:1、采用Log-rank检验进行单因素分析,结果显示:神经侵犯、脉管侵犯、分化程度、Lauren分型、浸润深度、淋巴结转移、是否放疗对Ib-IIIc期胃癌根治术后患者的预后影响有统计学差异;而性别、年龄对预后的影响无统计学差异;2、将上述单因素分析中有统计学差异的因素纳入Cox风险比率模型进行多因素回归分析,结果显示:神经侵犯、脉管侵犯、分化程度、浸润深度、淋巴结转移是影响Ib-IIIc期胃癌根治术后患者预后的独立因素。结论:神经侵犯、脉管侵犯、分化程度低、弥漫型、肿瘤浸润深度、淋巴结转移、未行放疗为Ib-IIIc期胃癌根治术后患者的预后不良因素。其中神经侵犯、脉管侵犯、分化程度、浸润深度、淋巴结转移为Ib-IIIc期胃癌根治术后患者的独立预后因素。
[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.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.2

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