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目的探讨影响食管胃结合部腺癌(adenocarcinoma of the esophagogastric junction,AEG)患者预后的相关因素,以期指导临床工作。方法回顾性分析我院普外科2004年1月~2006年12月行手术治疗且经病理确诊为胃食管结合部腺癌的181例患者的临床病历资料,统计分析患者的临床相关因素对预后的影响。结果全组1、3、5年总的生存率分别为83.4%,55.2%,30.9%。通过分析得出3种AEG分型患者术后生存差异无统计学意义(P>0.05),而与年龄、肿瘤浸润深度、是否淋巴结转移和远处转移、组织学分化程度、是否侵犯胃壁神经及临床TNM分期差异有统计学意义(P<0.05)。Cox多因素分析显示,肿瘤浸润深度和淋巴结转移是影响患者术后生存的独立因素(P<0.05)。结论患者预后与不同Siewert分型及性别无明显相关,与年龄、肿瘤浸润深度、是否淋巴结转移和远处转移、组织学分化程度、是否侵犯胃壁神经及临床TNM分期存在相关,其中肿瘤的浸润深度及淋巴结转移是影响AEG术后生存的独立因素。
Objective To investigate the prognostic factors of patients with adenocarcinoma of the esophagogastric junction (AEG) in order to guide the clinical work. Methods A retrospective analysis of our hospital from January 2004 to December 2006 in our department surgical treatment and pathological diagnosis of gastroesophageal junctional adenocarcinoma of 181 patients with clinical medical records, statistical analysis of patients with clinically relevant factors in prognosis influences. Results The overall 1, 3, 5-year overall survival rates were 83.4%, 55.2% and 30.9% respectively. Through analysis, there was no significant difference in postoperative survival between the three AEG classification patients (P> 0.05), but not with age, tumor invasion depth, lymph node metastasis and distant metastasis, histological differentiation, Clinical TNM staging difference was statistically significant (P <0.05). Cox multivariate analysis showed that the depth of tumor invasion and lymph node metastasis were independent prognostic factors for postoperative survival (P <0.05). Conclusion The prognosis of patients with different Siewert type and gender were not significantly correlated with age, tumor invasion depth, lymph node metastasis and distant metastasis, histological differentiation, whether invasion of gastric wall and clinical TNM staging exist, including depth of invasion of the tumor And lymph node metastasis are independent factors that affect the survival of AEG.