【摘要】 目的通过回顾性分析胃癌患者的临床资料,对胃癌转移结肠癌的危险因素及其组织学类型相关性进行研究,为早期诊治胃癌转移结肠癌提供有力依据。方法选取2013年1月至2015年11月我院肿瘤科收治的132例胃癌患者为研究对象,依据是否有结肠癌转移分为观察组和对照组,两组均行胃癌根治术。通过一般资料和病历整理以及术后病理学组织研究,分析性别、年龄、胃癌病灶部位、病灶大小、病理组织学类型、浸润深度、淋巴结转移情况与胃癌转移结肠癌间的关系。结果通过临床观察和严格诊断,两组单因素分析结果显示,胃癌转移结肠癌与性别、年龄无关(P>0.05),与胃癌病灶部位、病灶大小、浸润深度、淋巴结转移情况密切相关(P<0.05),其中病灶部位在胃窦(51.28%)、胃底体贲门处(66.67%)、病灶大小≥5 cm者(64.10%)、浸润深度在浆膜内(T1-2)处(72.22%)、淋巴结转移数目>6个(64.10%)更易发结肠癌转移。胃癌术后病理组织学检查发现胃癌转移结肠癌危险因素与组织学类型(高分化腺癌、中分化腺癌、低分化腺癌、黏液腺癌、印戒细胞癌)密切相关(P<0.05),其中低分化腺癌39.74%、黏液腺癌20.51%、印戒细胞癌32.05%与高、中分化腺癌比更易发生转移(P<0.05)。结论胃癌转移结肠癌的危险因素有胃癌病灶部位、病灶大小、病理组织学类型、浸润深度、淋巴结转移,且病灶部位在胃窦、胃底体贲门处、病灶大小≥5 cm者、浸润深度在浆膜内(T1-2)处、淋巴结转移数目>6个、组织学类型为低分化腺癌、黏液腺癌、印戒细胞癌者更易发生结肠癌转移。更多还原

【Abstract】 Objective To study the risk factors of gastric cancer metastasis of colon cancer and its correlation with histological type through retrospective analysis of the clinical data of patients with gastric cancer, and to provide strong basis for the early diagnosis and treatment of gastric cancer metastasis of colon cancer. Methods 132 cases of patients with gastric cancer who were treated in the oncology department of our hospital between January2013 and November 2015 were selected as the study objects. According to whether with colon cancer metastasis,the patients were divided into the observation group and the control group. Both of the two groups underwent radical operation for gastric cancer. The general data and medical records were collected and postoperative pathological study was performed to analyze the correlation between gender, age, lesion location of gastric cancer, size of lesion, histopathological type, depth of invasion, lymph node metastasis and gastric cancer metastasis of colon cancer. Results Through clinical observation and strict diagnosis, the univariate analysis showed that gastric cancer metastasis of colon cancer was not correlated with gender and age(P > 0.05), but is was closly correlated with lesion location of gastric cancer, size of lesion, histopathological type, depth of invasion and lymph node metastasis(P < 0.05). Patients whose lesion located in gastric antrum(51.28%), gastric fundus cardia(66.67%), lesion size ≥ 5cm(64.10%), depth of invasion in serosa(T1-2)(72.22%) and number of lymph node metastasis > 6(64.10%) tended to have colon cancer metastasis. Histopathological examination after operation for gastric cancer found that the risk factors of gastric cancer metastasis of colon cancer and histological type( high differentiated adenocarcinoma, moderately differentiated adenocarcinoma, poorly differentiated adenocarcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma) were closely related(P < 0.05). Metastasis was much easily to occur in poorly differentiated adenocarcinoma(39.74%), mucinous adenocarcinoma(20.51%) and signet-ring cell carcinoma(32.05%), compared with high and moderately differentiated adenocarcinoma(P <0.05). Conclusions The risk factors for gastric cancer metastasis of colon cancer include lesion location of gastric cancer, size of lesion, histopathological type, depth of invasion and lymph node metastasis. Patients whose lesion located in gastric antrum and gastric fundus cardia, lesion size ≥ 5cm, depth of invasion in serosa(T1-2) and number of lymph node metastasis > 6, whose histopathological type is poorly differentiated adenocarcinoma, mucinous adenocarcinoma and signet-ring cell carcinoma are prone to have colon cancer metastasis.更多还原