• 1.復(fù)旦大學(xué)醫(yī)學(xué)院（原上海醫(yī)科大學(xué)）附屬中山醫(yī)院外科（上海200032）;;
  • 2.復(fù)旦大學(xué)公共衛(wèi)生學(xué)院勞動(dòng)衛(wèi)生教研室（上海200032）;

目的探討胃癌的生物學(xué)特性及與臨床之間的關(guān)系。方法對(duì)1034例各期、各個(gè)部位的胃癌的臨床及病理資料進(jìn)行回顧性分析。結(jié)果早期胃癌148例，占總數(shù)的14.3%； 胃體和胃底部的胃癌淋巴結(jié)轉(zhuǎn)移率明顯高于其它部位的胃癌（P＜0.0001）； 腫瘤直徑大的胃癌分化差（P=0.004）、浸潤深（P＜0.0001），淋巴結(jié)轉(zhuǎn)移率也較高（P＜0.01）。浸潤深度較深的胃癌患者平均年齡大于浸潤深度較淺的患者（P=0.003），分化差的患者平均年齡低于分化好的患者（P＜0.0001）。女性患者的腫瘤相當(dāng)一部分位于胃的近端，男性則以位于胃的遠(yuǎn)端為多見（P＜0.001）； 女性患者腫瘤分化差的比例高于男性（P＜0.001），淋巴結(jié)轉(zhuǎn)移率 gt;30%以上者也比男性高（P=0.01）。多因素線性多元回歸分析發(fā)現(xiàn)，腫瘤部位（P=0.003）、直徑（P＜0.0001）、浸潤深度（P＜0.0001）及分化程度（P＜0.001）與淋巴結(jié)轉(zhuǎn)移密切相關(guān)，女性患者較男性更易發(fā)生淋巴結(jié)轉(zhuǎn)移（P＜0.001），其中決定淋巴結(jié)轉(zhuǎn)移最重要的因素是腫瘤浸潤胃壁的深度。全胃切除術(shù)清掃的淋巴結(jié)數(shù)最多，其次為遠(yuǎn)端胃大部切除術(shù)； 術(shù)后并發(fā)癥發(fā)生率最高的手術(shù)是經(jīng)腹近端胃大部切除術(shù)（17%）。結(jié)論為降低術(shù)后復(fù)發(fā)，對(duì)各期胃癌手術(shù)時(shí)均應(yīng)進(jìn)行淋巴結(jié)的清掃。

引用本文： 牛偉新逄兵秦新裕王承培. 1034例胃癌的臨床及病理學(xué)分析. 中國普外基礎(chǔ)與臨床雜志, 2002, 9(3): 145-147. doi: 復(fù)制

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