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目的:分析血清甲胎蛋白阳性胃癌患者的临床病理特征、治疗和预后。方法:分析我科2006年6月—2011年6月收治血清AFP阳性胃癌(AFPGC)患者54例,并以同期收治的67例血清AFP正常胃癌(非AFPGC)患者作为对照。对两组患者的临床病理特征、相关治疗药物及生存资料进行随访,并进行统计学分析。结果:与非AFPGC组相比,AFPGC组患者分化程度更差(P=0.042),肿瘤体积更大(P=0.030),临床分期更晚(P=0.015),肝转移比率更高(P=0.001)。AFPGC组与非AFPGC组患者的1年、2年和5年生存率分别为59.3%、25.9%、3.7%和82.1%、53.7%和14.9%,差异有统计学意义(P<0.05)。两组患者中位生存时间分别为15个月及25个月(P<0.05)。两组患者药物治疗之间差异无统计学意义(P>0.05)。结论:AFPGC是一种特殊类型的胃癌,其恶性程度高,治疗效果差,预后差。需进一步研究改善其生存率。
Objective: To analyze the clinicopathological characteristics, treatment and prognosis of patients with serum alpha-fetoprotein positive gastric cancer. Methods: 54 cases of AFP positive gastric cancer (AFPGC) were treated in our department from June 2006 to June 2011, and 67 cases of normal AFPGC (non-AFPGC) serum were enrolled in this study. The clinicopathological features, related therapeutic drugs and survival data of two groups were followed up and analyzed statistically. Results: The AFPGC group had worse differentiation (P = 0.042), larger tumor volume (P = 0.030), later clinical stage (P = 0.015) and higher hepatic metastasis rate than non AFPGC group (P = 0.001). The 1-year, 2-year and 5-year survival rates of patients with AFPGC and non-AFPGC were 59.3%, 25.9%, 3.7% and 82.1%, 53.7% and 14.9%, respectively, with statistical significance (P <0.05). The median survival time was 15 months and 25 months in both groups (P <0.05). There was no significant difference between the two groups in the drug treatment (P> 0.05). Conclusion: AFPGC is a special type of gastric cancer with high malignant degree, poor therapeutic effect and poor prognosis. Further study is needed to improve its survival rate.