摘要
目的观察中间入路近端残胃癌切除术后癌胚抗原（CEA）的表达及远期生存期。方法回顾性分析2013年1月至2016年1月收治的84例近端残胃癌患者的临床资料。结果观察组进腹时、全胃切除术时门静脉血CEA-mRNA阳性率与对照组比较差异无统计学意义（P〉0．05），但淋巴结清扫结束时门静脉血CEA-mRNA阳性率明显低于对照组（P〈0.05）。观察组手术时间、胃肠恢复时间、开始进食时间、下床活动时间均显著短于对照组（P〈0．05），术中出血量显著低于对照组（P〈0．05），但淋巴结清扫数量较对照组差异无统计学意义（P〉0.05）。观察组根治性切除率为100．00％，术后感染率为11．90％；对照组根治性切除率为80.10％，术后感染率为30．95％，两组根治性切除率与术后感染率比较差异均有统计学意义（P〈0.05）。观察组进腹、清扫淋巴结结束、残胃切除时门静脉血中CEA-mRNA阳性患者术后1~3年肿瘤远处转移率为88．89％，对照组为100．00％，差异无统计学意义（P〉0．05）；观察组门静脉血中CEA-mRNA阴性患者术后1—3年肿瘤远处转移率为25.81％，对照组为54.55％，差异有统计学意义（P〈0．05）。观察组术后3年生存率为71．43％，对照组为50％，差异有统计学意义（P〈0．05）。结论中间入路行近端残胃癌切除术近远期疗效确切．根治性切除率高．术后感染率低．值得临床积极借鉴。
Objective To observe the expression of carcinoembryonic antigen （ CEA ） and the long term survival period after the resection of proximal gastric stump carcinoma. Methods The clinical data of 84 patients with proximal gastric stump cancer from January 2013 to January 2016 were analyzed retrospectively. Results No significant difference was found in the positive rate of portal vein blood CEA-mRNA between the observation group （9.52%, 4.76%） and the control group （14.29%, 7.14%） when entering the abdomen and total gastrectomy （P〉0.05） , but the portal vein blood CEA-mRNA positive rate （4.76%） at the end of the lymph node dissection was significandy lower than the control group （26.19%） , a statistically significant difference （ P〈0.05 ） was found.The operative time, gastrointestinal recovery time, eating time and ambulation time in the observation group were significantly shorter than those in the control group （ P〈0.05 ） , and the intraoperative blood loss was significantly lower than that in the control group （P〈0.05） , but the number of lymph node dissection was not statistically significant compared with that in the control group （ P〉0.05 ） .The rate of radical resection in the observation group was 100%, and the infection rate after operation was 11.90%. In the control group, the radical resection rate was 80.10%, and the postoperative infection rate was 30.95%. There was a statistically significant difference between the two groups in radical resection rate and postoperative infection rate （P〈0.05） .In the observation group, the distant metastasis rate of portal vein blood was 1-3 in the observation group and 88.89% in the control group after operation. The difference between the two groups was not statistically significant （ P〉0.05 ） . The metastasis rate of CEA-mRNA in the portal vein was significantly higher than that in the control group. The distant metastasis rate of CEA-mRNA negative patients in the observation group was 25.81% in the 1~3 years after operation and 54.55% in the control group, with a statistically significant difference （P〈0.05） .The 3 year survival rate of the observation group was 71.43%, and the control group was 50%. The difference was statistically significant （ P〈0.05 ） .Conclusion The resection of proximal stump carcinoma with intermediate approach is effective, the rate of radical resection is high and the infection rate is low after operation. It is worthy of clinical use for reference.
出处
《浙江临床医学》
2018年第6期1066-1068,共3页
Zhejiang Clinical Medical Journal
关键词
中间入路
残胃癌
胃切除术
CEA表达
生存期
Intermediate approach
Gastric stump cancer
Gastrectomy
CEA expression
Life period
