可切除胃癌患者神经侵犯的危险因素及预后分析

Risk Factors and Prognosis of Preineural In-vasion in Patients with Resectable Gastric Cancer

摘要: 分析胃癌患者的临床病理特征，探讨发生神经侵犯(PNI)的相关危险因素及对患者预后的影响。回顾性分析接受手术切除的688例I~III期胃癌患者资料，根据是否发生神经侵犯分为PNI阳性组(556例)与PNI阴性组(132例)。Logistic单因素和多因素分析患者临床病理特征与PNI的关系。利用生存分析研究胃癌患者神经侵犯与生存率之间的关系。结果单因素分析结果显示，CA199、肿瘤大小、浸润深度、淋巴结转移、TNM分期、是发生神经侵犯的危险因素(P < 0.05)。多因素分析结果显示，肿瘤浸润程度深是发生神经侵犯的独立风险因素。神经侵犯阳性的患者5年生存率明显低于神经侵犯阴性的患者，两者的差异有统计学意义(P < 0.05)，且浸润程度越深越容易发生神经侵犯。我们建议神经侵犯阳性的胃癌患者，可以采取更积极的治疗手段。建议进一步研究以探讨神经侵犯的发生机制和更好的治疗方案。

Abstract: To analyze the clinicopathological characteristics of gastric cancer patients, and to explore the risk factors related to preineural invasion (PNI) and its impact on their prognosis. A retrospective anal-ysis was performed for the data of 688 patients with stage I~III gastric cancer who underwent sur-gical resection, and divided into PNI-positive group (556 cases) and PNI-negative group (132 cases) according to whether neuroaggression occurred. Logistic univariate and multivariate analysis of the relationship between clinicopathological features and LVI in patients. Survival analysis was used to study the relationship between neuroaggression and survival in gastric cancer patients. Results univariate analysis showed that CA199, tumor size, depth of invasion, lymph node metastasis, TNM stage, and risk factors for neuroaggression (P < 0.05). Multivariate analysis showed that deep tumor invasion was an independent risk factor for neuroaggression. The 5-year survival rate of gastric cancer patients with PNI-positive was significantly lower than that of patients with PNI-negative, the difference between them was statistically significant (P < 0.05), and patients with deeper invasion of gastric cancer were more likely to develop preineural invasion. We advised that patients with gastric cancer who may have preineural invasion should be treated more aggressively. Further re-search is recommended to explore the mechanisms of neuroaggression and better treatment op-tions.