ABO血型与胃癌患者预后关系的研究

发布时间：2018-06-09 03:22

  本文选题：胃癌 + 临床病理特征　； 参考：《第四军医大学》2016年硕士论文

【摘要】：目的1.探讨ABO血型与胃癌患者临床病理特征及预后的关系;2.评估不同肿瘤标志物水平的四种ABO血型胃癌患者的预后差异;3.评估术前血清CEA对四种ABO血型胃癌患者的预后指导价值。方法1.回顾性收集2008年6月至2013年10月间第四军医大学第一附属西京医院消化外科诊断为胃癌并接受根治性手术治疗的2838例患者的临床及随访资料,分析血型分布与胃癌患者临床病理特征的相关性,并比较不同血型胃癌患者的预后差异。2.回顾性收集我院消化外科2008年6月至2015年4月接受根治性手术治疗且术前检测血清肿瘤标志物的3307例胃癌患者的临床及随访资料,以四种术前血清肿瘤标志物水平为分层,比较各分层不同血型之间的预后差异。3.在第二部分基础上,筛选有术前血清CEA检测的我院消化外科2008年6月至2015年4月间的3297例胃癌患者的临床及随访资料。评估术前血清CEA水平在不同ABO血型胃癌患者中的预后指导作用。结果1.ABO血型分布与胃癌患者的临床病理特征没有显著关联(均P0.05),A,B,O,AB血型胃癌患者的5年总体生存率分别为57.3%,54.7%,57.4%,53.5%。不同血型的胃癌患者总体生存率差异没有统计学意义(P=0.722),然而在AJCCⅢ期或有吸烟史的胃癌患者中,非AB血型(A,B,O)胃癌患者的总体生存率显著低于AB血型胃癌患者(Ⅲ期44.7%比25.2%,P=0.014;吸烟史:74.9%比53.4%,P=0.044)。2.不同肿瘤标志物水平的四种血型患者预后差异没有统计学意义(均P0.05),然而在660例术前血清CEA阳性的胃癌患者中,AB血型患者生存时间显著高于非AB血型患者(P=0.014),中位生存期分别为58.2月和25.2月,5年总体生存率为45.8%和35.4%。多因素生存分析显示:对于CEA阳性的胃癌患者,AB血型是其有利且独立的预后影响因素。3.在总体胃癌患者预后影响的多因素生存分析中,术前血清CEA是预后的独立危险因素(P0.001),分别在A型血、B型血、O型血胃癌患者的多因素生存分析中,CEA均是其预后的独立危险因素(均P0.001),然而对于AB血型胃癌患者,单因素和多因素生存分析提示CEA不是影响预后的独立危险因素(P=0.189,P=0.956)。在总体中,CEA阴性和CEA阳性患者的5年总体生存率分别为61.3%和36.3%,在A型血患者中分别为61.7%和33.5%,在B型血中分别为61.3%和38.9%;在O型血中为62.4%和32.2%(均P0.001),在AB血型中分别为57.9%和45.8%(P=0.189)。结论1.ABO血型分布与胃癌患者的临床病理特征无明显关联,对于总体而言,血型不是胃癌患者的独立预后因素,但在Ⅲ期患者以及有吸烟史的患者中,AB血型可提示更好的预后。2.对于术前血清CEA阳性的胃癌患者而言,AB血型可提示更好的预后。3.对于非AB血型(A,B和O)胃癌患者,术前CEA是影响其预后的独立危险因素,然而对于AB血型胃癌患者,CEA并不是影响预后的独立危险因素。
[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，

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