目的:回顾性分析影响Ⅳ期胃癌患者生存预后的相关因素,评价中西医结合治疗对Ⅳ期胃癌患者生存时间的影响.方法:采用回顾性调查研究方法,分析210 例Ⅳ期胃癌患者病历资料.用Kaplan-Meier计算生存率,用Log Rank检验法进行单因素分析,用COX回归模型进行多因素分析.结果:Log Rank单因素分析结果显示,手术、性别、年龄、肿瘤家族史、病理分型、腹膜转移、其他转移与Ⅳ期胃癌患者生存预后无明显相关性(P＞0.05);中药、发病部位、分化程度、肝转移、远处淋巴结转移、CEA和CA199 与Ⅳ期胃癌患者生存预后有相关性(P＜0.05).COX多因素分析结果显示中药、分化程度、CEA、CA199 是Ⅳ期胃癌患者生存预后的独立影响因素(P＜0.05).中药是Ⅳ期胃癌患者生存预后的保护因素,低分化、CEA和CA199 的高表达是Ⅳ期胃癌患者生存预后的危险因素.结论:中西医结合治疗可延长Ⅳ期胃癌患者生存时间.
Objective:To retrospectively analyze the relevant factors affecting the survival prognosis of stage Ⅳ gastric cancer patients and evaluate the impact of combined treatment of traditional Chinese and Western medicine on the survival time of stage Ⅳ gastric cancer patients.Method:A retrospective survey was conducted to analyze the medical records of 210 patients with stage Ⅳ gastric canc-er.Calculate survival rate using Kaplan-Meier,conduct univariate analysis using Log Rank test,and conduct multivariate analysis using COX regression model.Result:Log Rank univariate analysis showed that surgery,gender,age,tumor family history,pathological classifi-cation,peritoneal metastasis,and other metastases were not significantly correlated with the survival prognosis of stage Ⅳ gastric cancer(P＞0.05);Traditional Chinese medicine,site of onset,degree of differentiation,liver metastasis,distant lymph node metastasis,CEA and CA199 are correlated with the survival prognosis of stage Ⅳ gastric cancer(P＜0.05).The results of COX multivariate analysis showed that traditional Chinese medicine,degree of differentiation,CEA,and CA199 were independent influencing factors on the surviv-al prognosis of stage Ⅳ gastric cancer patients(P＜0.05).Traditional Chinese medicine is a protective factor for the survival and prog-nosis of stage Ⅳ gastric cancer,while low differentiation,high expression of CEA and CA199 are risk factors for the survival and progno-sis of stage Ⅳ gastric cancer.Conclusion:The combination of traditional Chinese and Western medicine treatment can prolong the sur-vival time of patients with stage Ⅳ gastric cancer.
刘亚南;王玲玲;刘培民;王玉萍;张娟;马纯政
河南中医药大学第二附属医院/河南省中医院,河南 郑州 450002
中医学
Ⅳ期胃癌;生存时间;预后因素;中西医结合;中药
stage Ⅳ gastric cancer;survival time;prognostic factors;combined treatment of integrative medicine;traditional Chinese medicine
《中医学报》 2024 (001)
205-209 / 5
10.16368/j.issn.1674-8999.2024.01.034
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