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目的:分析食管胃结合部腺癌及胃癌各自的独立预后影响因素。方法:收集本院2007年1月至2011年6月院340例术后食管胃结合部腺癌及胃癌病例,选择13项临床病理因素(性别、年龄、病变长度、病理类型、淋巴结转移情况、浸润深度、临床分期、周围器官受侵情况、残端情况、脉管瘤栓、术中淋巴结清扫程度及出现症状到首诊治疗时间)分别进行Cox单因素及多因素分析。结果:1)食管胃结合部腺癌与胃癌比较预后更差;2)淋巴结清扫及淋巴结转移均为二者的独立预后影响因素,淋巴结转移个数越多,患者预后越差,D2式手术较D1式手术可能带来更大的生存获益;3)浸润深度为食管胃结合部腺癌的独立预后影响因素,浸润越深预后越差;而病变长度为胃癌的独立预后影响因素,病变越长预后越差。结论:与胃癌相比,食管胃结合部腺癌预后更差,并且有其独特的临床病理特征及预后影响因素,提示二者有所区别,今后应将食管胃结合部腺癌做为一种独立的疾病开展更加深入的研究。
Objective: To analyze the influencing factors of the independent prognosis of esophageal and gastric cancer and adenocarcinoma respectively. Methods: A total of 340 cases of esophageal and gastric cancer with esophagogastric junction were collected from January 2007 to June 2011 in our hospital. Thirteen clinical and pathological factors (gender, age, length of lesion, pathological type, lymph node metastasis, Depth of invasion, clinical stage, invasion of surrounding organs, stump, tumor thrombus, degree of lymph node dissection and symptom onset to treatment time were analyzed by Cox univariate and multivariate analysis respectively. Results: 1) The prognosis of esophageal-gastric adenocarcinoma was worse than that of gastric adenocarcinoma; 2) Lymph node dissection and lymph node metastasis were both independent prognostic factors. The more the number of lymph node metastasis, the worse the prognosis, D1 surgery may lead to greater survival benefit; 3) depth of invasion of esophageal and gastric adenocarcinoma of independent prognostic factors, the deeper the deeper the prognosis of the worse; and the length of the lesion is an independent prognostic factor for gastric cancer, lesion The worse the long-term prognosis. Conclusions: The prognosis of esophageal-gastric adenocarcinoma is worse than that of gastric cancer, and has its unique clinicopathological features and prognostic factors, suggesting that the difference between them is that esophagogastric junctional adenocarcinoma should be regarded as one Independent disease to carry out more in-depth study.