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目的探讨胃近端、远端癌的临床和预后的差异及其原因。方法将我院1994年6月至2001年6月经手术治疗的365例胃癌患者的临床、病理及定期随访资料输入数据库,对其一般临床资料、预后因素及生存率进行分析。结果胃近端、远端癌的发病年龄差异无显著性意义(P=0.052),但胃近端癌男性发病的比例较高。标本大体分型中,两组Borrmann分型差异无显著性意义(P=0.6),但胃近端癌的TNM分期较晚,特别是淋巴结转移率明显高于胃远端癌,组织分化类型则无明显差别。虽然胃近端癌全胃切除率较高,但手术并发症发生率和死亡率并无明显增高。胃近端癌手术后的生存率较胃远端癌低。结论胃近端癌预后较胃远端癌差,其重要原因可能与肿瘤的位置特殊、出现症状较晚及就诊时肿瘤分期较晚有关,而与手术并发症发生率和手术死亡率无明确的关系。
Objective To investigate the differences and causes of clinical and prognosis of proximal gastric cancer and distal cancer. Methods The clinical, pathological and regular follow-up data of 365 patients with gastric cancer who underwent surgery from June 1994 to June 2001 in our hospital were input into the database, and their clinical data, prognostic factors and survival rate were analyzed. Results There was no significant difference in the age of gastric cancer between the proximal and distal cancers (P = 0.052), but the incidence of gastric cancer in men was higher. There was no significant difference in Borrmann classification between the two groups (P = 0.6), but TNM stage of gastric proximal cancer was late, especially lymph node metastasis was significantly higher than distal gastric cancer, while the type of tissue differentiation No significant difference. Although the rate of total gastrectomy in proximal gastric cancer is high, the incidence and mortality of surgical complications are not significantly increased. The survival rate of proximal gastric cancer after surgery is lower than distal gastric cancer. Conclusions The prognosis of gastric proximal cancer is worse than that of distal gastric cancer. The main reason may be related to the special location of the tumor, late onset of symptoms and late stage of the tumor at the time of diagnosis, but not related to the incidence of surgical complications and operative mortality relationship.