中国普外基础与临床杂志

中国普外基础与临床杂志

Ⅱ/Ⅲ型胃食管结合部腺癌淋巴结转移的影响因素及其对预后的影响

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目的 探索 Siewert Ⅱ/Ⅲ型胃食管结合部腺癌(AEG)淋巴结转移的影响因素及其对患者预后的影响。 方法 回顾性分析 2010 年 1 月至 2013 年 1 月期间十堰市中医医院收治的 49 例 Siewert Ⅱ/Ⅲ型 AEG 患者的临床病理学资料。AEG 淋巴结转移影响因素的单因素和多因素分析分别采用成组 χ2检验和非条件 logistic 回归模型;淋巴结转移对患者预后的影响分析采用 log-rank 检验。 结果 多因素非条件 logistic 回归分析结果显示,肿瘤直径(P=0.008)、浸润深度(P=0.019)、脉管癌栓(P=0.020)和分化程度(P=0.017)均是淋巴结转移的影响因素。无淋巴结转移的 Siewert Ⅱ/Ⅲ型 AGE 患者的生存情况优于淋巴结转移者(P=0.005)。 结论 肿瘤直径、侵犯深度、分化程度和脉管癌栓是影响 Siewert Ⅱ/Ⅲ型 AEG 患者淋巴结转移的独立危险因素,且淋巴结转移与患者的不良预后有关。

Objective To explore the influencing factors of lymph node metastasis of Siewert Ⅱ/Ⅲ gastroesophageal junction adenocarcinoma (AEG) and its influence on prognosis of this kind of patients. Methods The clinical and pathological data of 49 patients with Siewert Ⅱ/Ⅲ AEG who admitted to Shiyan Hospital of Traditional Chinese from January 2010 to January 2013 were retrospectively analyzed. Univariate and multivariate analyses of factors affecting lymph node metastasis of AEG were performed by using a chi-square test and an unconditional logistic regression model; the effect of lymph node metastasis on the prognosis of patients with Siewert Ⅱ/Ⅲ AEG was performed by log-rank test. Results Multivariate unconditional logistic regression analysis showed that, tumor diameter (P=0.008), depth of invasion (P=0.019), vascular tumor thrombus (P=0.020), and degree of differentiation (P=0.017) were all influencing factors of lymph node metastasis. Patients with Siewert Ⅱ/Ⅲ AGE without lymph node metastasis had better survival than those with lymph node metastasis (P=0.005). Conclusion Tumor diameter, depth of invasion, degree of differentiation, and vascular tumor thrombus are independent risk factors for lymph node metastasis in patients with Siewert Ⅱ/Ⅲ AEG, and lymph node metastasis is associated with poor prognosis.

关键词: 胃食管结合部腺癌; 淋巴结转移; 预后

Key words: adenocarcinoma of gastroesophageal junction; lymph node metastasis; prognosis

引用本文: 高军, 李富良, 何旭. Ⅱ/Ⅲ型胃食管结合部腺癌淋巴结转移的影响因素及其对预后的影响. 中国普外基础与临床杂志, 2018, 25(11): 1327-1331. doi: 10.7507/1007-9424.201806013 复制

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