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目的:探讨淋巴结转移阴性胃癌患者的临床病理特征以及预后影响因素。方法:收集2000年1月至2009年1月我院收治的胃癌患者325例,其中经病理检查显示淋巴结转移阴性的105例患者作为阴性组(LN-组),另229例阳性患者作为阳性组(LN+组),比较两组的临床病理特征及临床预后。结果:LN-组的肿瘤直径、浸润深度及术后化疗与LN+组比较差异显著(P<0.05);LN-组的5年生存率为76.2%,显著高于LN+组的43.2%(P<0.05)。未透浆膜的LN-患者3年、5年生存率显著高于浸透浆膜者,术后化疗的LN-患者5年生存率显著高于未化疗者(P<0.05),肿瘤直径<5 cm的LN-患者3、5年生存率显著高于≥5 cm者(P<0.05)。单因素分析显示浸润深度、肿瘤大小及术后化疗与LN-胃癌患者的预后具有密切关系(P<0.05)。COX多因素分析显示浸润深度是影响LN-胃癌患者临床预后的独立因素(P<0.05)。结论:淋巴结转移阴性胃癌患者的病灶多位于中下部,男性多于女性,发病年龄多在60岁以内,肿瘤直径多不超过5 cm,浸润深度多未浸透浆膜,临床预后优于淋巴结转移阳性胃癌患者,浸润深度是影响淋巴结转移阴性胃癌患者临床预后的独立因素。
Objective: To investigate the clinicopathological characteristics of patients with lymph node metastasis-negative gastric cancer and prognostic factors. Methods: A total of 325 gastric cancer patients admitted to our hospital from January 2000 to January 2009 were collected. Among them, 105 patients with negative lymph node metastasis were negative (LN- group) and 229 positive patients (positive) (LN + group). The clinicopathological features and clinical prognosis of the two groups were compared. Results: The tumor diameter, depth of infiltration and the postoperative chemotherapy in LN - treated group were significantly different from that in LN + group (P <0.05). The 5 - year survival rate was 76.2% in LN - group, significantly higher than that in LN + group (43.2%, P < 0.05). The 3-year and 5-year survival rate of LN-patients with no serous membrane was significantly higher than that of those with plasma membrane infiltration. The 5-year survival rate of patients with LN-positive postoperative chemotherapy was significantly higher than that of patients without chemotherapy (P <0.05) The 3-year and 5-year survival rates of patients with LN-cm were significantly higher than those with ≥5 cm (P <0.05). Univariate analysis showed that the depth of invasion, tumor size and postoperative chemotherapy were closely related to the prognosis of patients with LN-gastric cancer (P <0.05). COX multivariate analysis showed that the depth of invasion was an independent factor affecting the clinical prognosis of LN-GC patients (P <0.05). Conclusion: The lesions of patients with negative lymph node metastasis are mostly located in the middle and lower parts, more men than women. The age of onset is more than 60 years old. The diameter of tumor is no more than 5 cm. The depth of invasion is more than that of serosa. The clinical prognosis is better than that of lymph node metastasis Gastric cancer patients, depth of invasion is an independent factor affecting the clinical prognosis of patients with lymph node metastasis-negative gastric cancer.