胃癌肝转移患者的临床特征及预后生存分析

发布时间：2018-04-04 11:43

  本文选题：胃癌　切入点：肝转移　出处：《医学研究生学报》2017年02期

【摘要】：目的肝是胃癌转移的常见部位,但目前对于出现肝转移的胃癌患者尚无统一治疗规范。文中探讨胃癌肝转移患者的临床特征和预后因素,为提高胃癌肝转移患者诊治水平提供依据。方法对四川省人民医院2009年1月至2014年6月收治的143例胃癌肝转移患者的临床特征及生存资料进行回顾性分析,采用Cox回归模型探讨影响患者预后的独立危险因素。结果 143例胃癌肝转移患者中位生存期为14个月,1、2、3年生存率依次为52.4%、28.7%、12.6%。单因素分析显示,不同原发胃癌组织学分级、肝转移时间、肝转移癌类型、肝外转移情况和治疗方式的胃癌肝转移患者间的生存状况差异有统计学意义(P0.05)。多元Cox回归分析显示,胃癌组织学分级为低分化或未分化(HR=2.67,95%CI:1.51~4.72)、肝转移癌类型为H2(HR=1.89,95%CI:1.08~3.29)或H3(HR=2.13,95%CI:1.32~3.44)为胃癌肝转移患者预后的独立危险因素;姑息化疗(HR=0.55,95%CI:0.32~0.95)为胃癌肝转移患者预后的独立保护因素。结论胃癌肝转移患者预后较差。胃癌组织学分级低、肝转移癌类型为H2或H3的胃癌肝转移患者预后相对较差。接受姑息化疗的胃癌肝转移患者预后好于接受最佳支持治疗的患者,因此临床上应尽量考虑为使患者提供综合治疗机会。
[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鍥炲綊鍒嗘瀽鏄剧ず,鑳冪檶缁勭粐瀛﹀垎绾т负浣庡垎鍖栨垨鏈�鍒嗗專�

本文编号：1709817