胃癌病理资料回顾性研究及预后相关因素分析

发布时间：2018-07-01 20:15

本文选题：胃癌 + 病理　；参考：《延边大学》2015年硕士论文

【摘要】：目的探讨胃癌(GC)患者病理分型、肿瘤直径、转移、分期、GC后发生贫血间的相关性及影响预后因素。方法收集延边医院2004年1月至2013年12月10年间以GC为诊断在延边大学附属医院住院患者共1249例进行回顾性分析,其中病理资料完整者905例。计数资料差异性分析采用X2检验,等级资料采用秩和检验,计量资料采用方差分析和t检验,计数资料趋势检验采用X2检验,计量资料趋势检验采用方差分析,影响GC预后因素采用logistic回归分析；统计学分析采用SPSS 19.0统计软件,p0.05为差异有统计学意义结果1.2004年1月至2013年12月GC患者1249例,其中男924例,女325例,男女比例为2.84：1。2.GC患者年龄最小24岁,最大90岁,平均年龄61.40±10.61岁。依年龄特点可将GC分为三个阶段,即≤40岁、4 1至60岁及60岁,其中≤40岁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岁前5年237例(44.22%),近5年268例(37.59%),60岁前5年275例(51.30%),近5年426例(59.75%),近5年较前5年比较,GC患者年龄分布趋向老年人。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%),以低分化癌最多见；GC发生转移情况为,无转移253(28.0%)例,有淋巴转移322(35.6%)例,有周围脏器转移166(18.3%)例,远处转移164(18.1%)例,以淋巴转移最多见。高分化癌发生转移13例,转移率22.8%；中分化癌发生转移184例,转移率66.7%；低分化癌发生转移449例,转移率79.3%。分化程度越低,转移率越高。无转移的GC患者253例,直径3.11±1.90cm,淋巴转移的GC患者322例,直径4.04±1.73cm,脏器转移GC患者166例,直径4.58±1.94cm,远处转移GC患者164例,直径4.59±2.08 cm。直径越大,发生转移越远。4.高分化癌发生贫血21例,贫血发生率36.8%,中分化癌发生贫血147例,贫血发生率53.3%,低分化癌发生贫血250例,贫血发生率44.2%。GC患者发生贫血程度与肿瘤分化程度间差异无统计学意义,但是,有无贫血与肿瘤分化程度有关。Ⅰ、Ⅱ期GC患者504例,发生贫血190例,贫血发生率37.7%,Ⅲ、 Ⅳ期GC患者401例,发生贫血231例,贫血发生率57.6%,Ⅲ、Ⅳ期GC患者贫血发生率高于Ⅰ、Ⅱ期。GC患者无转移253例,发生贫血86例,贫血发生率34.0%；淋巴转移322例,发生贫血142例,贫血发生率44.1%；脏器转移166例,发生贫血压97例,贫血发生率58.4%,远处转移164例,发生贫血96例,贫血发生率58.5%。转移越远,贫血L发生率越高。5.至今为止,905例GC患者未愈死亡161例,病情好转患者744例。单因素分析发现,民族、Hb值、肿瘤分化程度、转移情况、治疗方式、病理分期、直径大小是影响GC的相关因素,年龄、性别、吸烟、饮酒、肝炎不是GC预后影响因素。多因素分析发现民族、Hb值、转移情况、治疗方式是影响GC预后的独立影响因素,其中朝鲜族、Hb异常、脏器和远处转移是危险因素；手术治疗手术+辅助治疗是保护因素。结论1.近5年GC患者年龄分布趋向于老龄化。2.GC患者肿瘤分化程度越低发生转移率越高；肿瘤直径越大,发生转移越远。3.GC患者发生转移越远,贫血发生率越高；Ⅲ、Ⅳ期GC患者贫血发生率高于Ⅰ、Ⅱ期。4.民族、Hb值、肿瘤分化程度、转移情况、治疗方式、病理分期、直径大小是GC患者预后的相关因素。5.朝鲜族、发生贫血、发生脏器和远处转移的GC患者预后差,经手术治疗和手术+辅助治疗的GC患者预后相对好。
[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.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.2

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