胃癌家族史与胃癌患者临床病理特征及预后的关系

摘要

目的 探讨有、无胃癌家族史的胃癌患者之间临床病理特征及预后的差异.方法 回顾性分析2011年至2015年456例胃癌患者的临床病例资料,其中有胃癌家族史者102例.采用双侧χ2检验分析有、无胃癌家族史患者的临床病理特征;生存分析用Kaplan-Meier法,并行Log-rank检验;用Cox比例风险模型分析影响胃癌预后的因素.结果 在有胃癌家族史的患者中,年龄≥50岁、肿瘤最大径<5 cm、组织学分级为Ⅰ~Ⅱ级以及M0分期的比例均显著高于无胃癌家族史者(P<0.05).有胃癌家族史患者的中位总生存时间(OS)为56.1个月,高于无胃癌家族史者的51.0个月(P=0.318);但在发病年龄<50岁的亚组中,有胃癌家族史患者的中位OS显著优于无胃癌家族史患者(未达vs.53.0个月,P=0.021).Cox比例风险模型显示,影响有胃癌家族史患者OS的因素为N分期和M分期(P<0.05),影响无胃癌家族史患者OS的因素为肿瘤最大径、肿瘤部位和M分期(P<0.05).结论 有、无胃癌家族史的胃癌患者之间存在临床病理特征的差异,其OS亦可能存在差异.%Objective To investigate the differences of clinicopathologic characteristics and prognoses of gastric cancer between patients with or without family history of gastric cancer.Methods A retrospective study was conducted in 456 gastric cancer patients from 2011 to 2015, and among them 102 cases were with family history of gastric cancer.A two-sided χ2 was used to test the difference of clinicopathologic characteristics between patients with or without family history of gastric cancer.Survival curves were calculated by Kaplan-Meier method with Log-rank test.Both univariate and multivariate Cox regression models were used to analyze risk factors that impact overall survival (OS).Results In patients with family history of gastric cancer, the proportions of patients with onset age ≥50 years, the longest diameter of tumor <5 cm, histological grade of Ⅰ-Ⅱ and M0 stage were significantly higher than that in patients without family history of gastric cancer (P<0.05).The median OS of patients with family history of gastric cancer was 56.1 months, longer than 51.0 months of those without family history of gastric cancer, but without statistic significance (P=0.318).However, in the subgroup of onset age ≥50 years, patients with family history of gastric cancer had OS superiority than those without family history of gastric cancer (unachieved vs.53.0 months, P=0.021).Furthermore, Cox regression models analysis showed that N stage and M stage were independent factors influencing OS in patients with family history of gastric cancer, and the longest diameter of tumor, tumors location and M stage were independent factors influencing OS in those without family history of gastric cancer.Conclusion Gastric cancer patients with or without family history of gastric cancer have different clinicopathologic characteristics, and OS between those patients may have certain difference.