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目的 探讨胃癌腹膜转移的临床病理特点以提供术前诊断的依据 ,并评估手术治疗的结果。方法 回顾性分析 5 7例胃癌腹膜转移病人的临床病理特点和生存情况。结果 5 7例胃癌腹膜转移病人中 ,女性年龄小于男性 (5 0 %vs 2 2 5 8% ,P <0 0 5 ) ,而且其手术切除率明显低于男性 (39 13%vs 6 7 85 % ,P <0 0 5 )。 5 1例手术病人中 ,35 2 9% (18/ 5 1)出现腹水 ,17 6 5 % (9/ 5 1)直肠指检发现肿块。生存分析表明姑息切除病人的生存时间明显长于未切除者 (P <0 0 0 1) ,Cox回归分析显示手术切除是影响预后的唯一因素 (相对危险度0 2 6 1) ,但腹膜转移为P3时手术切除率明显下降 (P <0 0 0 1)。结论 腹水和直肠指检发现肿块是胃癌腹膜转移的常见临床表现 ,其中女性病人年龄偏小且手术切除可能性也较小。如果可能应行姑息切除手术 ,但腹膜转移为P3时应慎重
Objective To investigate the clinicopathological features of peritoneal metastasis of gastric cancer to provide the basis for preoperative diagnosis and to evaluate the results of surgical treatment. Methods The clinical and pathological features and survival of 57 patients with peritoneal metastasis from gastric cancer were retrospectively analyzed. Results Among 57 patients with peritoneal metastasis of gastric cancer, the age of females was lower than that of males (50.0% vs 52.58%, P <0.05), and the surgical resection rate was significantly lower than that of males (39.13% vs 67 85% , P <0 0 5). Of the 5 surgical patients, 35 2 9% (18/5 1) had ascites and 17 6 5% (9/51) rectal examination found the mass. Survival analysis showed that the survival time of patients under palliative resection was significantly longer than that of patients without resection (P <0.01). Cox regression analysis showed that surgical resection was the only factor influencing prognosis (relative risk 0 2 6 1), but peritoneal metastasis was P3 When the surgical resection rate was significantly decreased (P <0 0 0 1). Conclusion Ascites and digital rectal examination found that the mass is a common clinical manifestation of peritoneal metastasis of gastric cancer. Female patients are younger and less likely to undergo surgical resection. Palliative surgery should be performed if possible, but peritoneal metastasis should be careful P3