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影响 Lauren分型胃癌患者行根治术治疗后早期复发的因素分析
黄庆峰,杨立成,吴建军
0
溧阳市人民医院普外科江苏溧阳 213300
摘要:
目的:探讨不同 Lauren分型胃癌患者的临床病理特征及患者行根治术后早期复发的独立影响因素。方法:选择 2016年 1月—2019年 4月于我院行根治性切除术的胃癌患者 236例,收集患者临床资料,对比不同 Lauren分型胃癌患者的临床特征。术后随访两年,根据随访期间患者复发情况将其分为复发组( 80例)和无复发组( 156例),采用多因素 Logistic回归分析患者胃癌根治术后早期复发的影响因素,构建列线图预测模型并验证。结果:肠型胃癌多发于男性,患者组织学分级较高,术后辅助化疗周期更长,癌组织中 Ki-67、HER-2高表达比例更高;弥漫型胃癌多发于女性,患者更易出现脉管瘤栓和周围神经浸润,肿瘤直径≥ 50 mm比例更高,淋巴结阳性率较肠型患者显著增加,差异有统计学意义( P<0.05)。肿瘤大小、Lauren分型、T分期、淋巴结阳性率及术后辅助化疗周期均为胃癌患者行根治术后早期复发的影响因素(P<0.05),依据独立影响因素构建列线图模型,其一致性指数为 0.745(95%CI:0.702~0.788),ROC曲线的 AUC为 0.726(95%CI:
关键词:  胃癌  Lauren分型  病理特征  根治术  早期复发
DOI:10.3969/j.issn.1007-6948.2022.03.008
投稿时间:2021-06-24
基金项目:
Analysis of Factors Influencing Early Recurrence of Lauren Type Gastric Cancer after Radical Resection
HUANG Qing-feng,YANG Li-cheng,WU Jian-jun
General Surgery Department, Liyang People’s Hospital, Liyang 213300, China
Abstract:
Objective To investigate the clinic pathological features of patients with different Lauren types of gastric cancer and the independent risk factors of early recurrence after radical resection. Methods 236 patients with gastric cancer who underwent radical resection in our hospital from January 2016 to April 2019 were selected. The clinical data were collected to compare the clinical characteristics of patients with different Lauren types of gastric cancer. The patients were followed up for two years. According to the recurrence during the follow-up period, they were divided into no recurrence group and recurrence group. The independent risk factors of early recurrence after radical gastrectomy were analyzed by univariate and logistic multivariate regression, and the nomogram prediction model was constructed and veri.ed. Results Intestinal gastric cancer was more common in men, with higher histological grade, longer postoperative adjuvant chemotherapy cycle and higher proportion of high expression of Ki-67 and HER-2 in cancer tissues (P<0.05). Diffuse gastric cancer is more common in women, and patients are more prone to vascular tumor emboli and peripheral nerve in.ltration. The proportion of tumor diameter ≥ 50 mm is higher, and the positive rate of lymph node is signi.cantly higher than that of patients with intestinal type (P<0.05). Tumor size, Lauren type, T stage, lymph node positive rate and postoperative adjuvant chemotherapy cycle were independent risk factors for early recurrence after radical resection of gastric cancer patients (P<0.05). The nomogram model was constructed according to independent risk factors. The consistency index was 0.745 (95%CI: 0.702~0.788) and the AUC of ROC curve was 0.726 (95%CI: 0.695~0.757), which had good discrimination. The evaluation results of calibration curve and model calibration curve showed that the prediction model was accurate. Conclusion The clinical characteristics of
Key words:  Gastric cancer  Lauren parting  pathological features  radical prostatectomy  early recurrence

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