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目的探讨胃癌根治术后复发转移的规律。方法回顾性分析行胃癌根治术患者的临床、病理、随访资料t,检验及2检验分析各种复发转移途径的危险因素。结果纳入患者1 076例,随访资料详细且复发转移者161例。其中肿瘤首发复发转移部位明确者124例,包括腹膜种植37例(30.0%)、淋巴结转移33例(26.6%)、血道转移32例(25.8%)、局部复发22例(17.6%)。经分析胃癌根治术后患者复发转移与浸润深度、肿瘤大小、脉管癌栓、肿瘤部位、淋巴结转移相关,其中腹膜种植与浸润深度、结缔组织浸润、肿瘤部位相关,淋巴结转移与淋巴结阳性、肿瘤大小相关,血道转移与脉管癌栓相关,局部复发与浸润深度相关。结论胃癌根治术后复发转移最常见为腹膜种植,其次为淋巴结转移、血道转移、局部复发。
Objective To investigate the rule of recurrence and metastasis of radical resection of gastric cancer. Methods The clinical, pathological and follow-up data of patients undergoing radical gastrectomy were analyzed retrospectively. The risk factors of various recurrence and metastasis were analyzed by χ2 test. Results A total of 1 076 patients were enrolled in this study. There were 161 patients with detailed follow-up and recurrence and metastasis. Among them, 124 cases were confirmed as tumor recurrence and metastasis, including 37 cases (30.0%) with peritoneal implantation, 33 cases (26.6%) with lymph node metastasis, 32 cases (25.8%) with hematogenous metastasis and 22 cases (17.6%) with local recurrence. The recurrence and metastasis of patients with radical resection of gastric cancer was associated with depth of invasion, tumor size, tumor thrombus, tumor location and lymph node metastasis. The depth of peritoneal implantation and invasion, connective tissue infiltration, tumor location, lymph node metastasis and lymph node positive, Size-related, hematogenous metastasis and vascular thrombosis related to local recurrence and depth of invasion. Conclusion The most common recurrence and metastasis of gastric cancer after radical resection is peritoneal implantation, followed by lymph node metastasis, hematogenous metastasis and local recurrence.