【摘要】 目的探讨对于胃癌患者如何在行肿瘤根治术的同时,不失其脾脏的抗肿瘤免疫功能。方法1991年1月至1994年7月间将39例Ⅲ期贲门胃体癌患者随机分为3组:根治组(13例)行根治性全胃切除;扩大根治组(12例)行根治性全胃切除术加胰体尾和脾切除术;脾移植组(14例)行扩大根治术加自体脾移植。术后通过随访,进行前瞻性对比观察。结果5年生存率:根治组为23.1%;扩大根治组为22.5%;脾移植组为50.0%。生存分析表明脾移植组5年生存率高于根治组(P=0.0463)和扩大根治组(P=0.0249),后两组间差异无显著性意义(P=0.6124)。术后两个月移植脾脏经99mTc同位素扫描全部清晰显影即恢复功能。结论自体脾组织移植能延长胃癌根治术后患者的5年生存率。更多还原

【Abstract】 Objective To investigate the outcomes of exten ded radical gastrectomy plus autotr ansp-lantation for gastric cancer.Methods From January 1991to July 1994,39cases with stageⅢgastric cancer were randomly divided into th ree groups:radical total gastrectomy group(n=13),extended radical gastrectomy group(n=12),extended radical gastrectomy plus spleen autotransplantation group(n=14).Follow-up and prospectively comparative observation were carried out t o compare the clinical outcomes.Results The postoperative 5-year survival r ates of radical total gastrectomy group,extended radical gastrectomy group,and extended rad ical gastrectomy plus spleen autotr ansplantation group were 23.1%,22.5%and 50.0%respectively.By mul tivariate analysis,the 5-year surv ival rate of extended radical gastrectomy plus spleen autotransp lantation was higher than those of ra dical total gastrectomy (P=0.0463)and extended radical gastrectomy (P=0.0249),while there was no significant diff erence between the later two groups(P=0.6124). 99m Tc isotope scan two months postopera tively revealed that the function of autotransplantated spleen recovered.Conclusion Extended radical gastrectomy plus s pleen autotransp-lantation can prolong the 5-year sur vival rate of the patients with gastr ic cancer.[更多还原