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Risk Factors for Recurrence of Gastric Cancer after Curative Resection in One University Hospital

한 대학병원 위암수술 환자의 재발에 영향을 주는 요인

  • Lee, Tae-Yong (Dept. of Preventive Medicine, School of Medicine, Chungnam National University) ;
  • Kim, Hyeon-Geun (Daejeon Metropolitan City Health Policy Division)
  • 이태용 (충남대학교 의학전문대학원 예방의학교실) ;
  • 김현근 (대전광역시 보건정책과)
  • Received : 2011.09.15
  • Accepted : 2011.11.10
  • Published : 2011.11.30

Abstract

In order to investigate recurrence rate and risk factors for recurrence of gastric cancer after curative resection, we examined blood biochemical profile and clinicopathological features of 386 gastric cancer patients by using medical charts and data of hospital cancer registry from September 2010 to May 2011. Chi-square test and logistic regression analyses were performed to identify risk factors. The recurrence rate of all gastric cancer patients was 2.6%; The recurrence rate by gender was 3.45% in male and 0.89% in female, and that was 4 times higher in male than in female. On univariate logistic regression analyses, lymph node metastases(OR=8.793), Helicobactor pylori infecton(OR=6.495), abnormal total cholesterol(OR=14.333) were related to recurrence. On multivariate logistic regression analyses, lymph node metastases and H. pylori infection were very important risk factors for recurrence of gastric cancer. In conclusion, lymph node metastases, H. pylori infection, and total cholesterol control were very important to prevent recurrence of gastric cancer, and it needs to monitor blood biochemical (C-reactive protein, carcinoembryonic antigen, etc) for the early detection of gastric cancer recurrence.

위암 완치수술을 받은 환자들의 재발수준과 재발에 미치는 영향을 파악하고자 2010년 9월부터 2011년 5월까지 한 대학병원에서 위암으로 진단받고 수술받은 환자 386명을 대상으로 조사하였다. 이들의 의무기록지와 병원암등록 자료에서 인구사회학적 특성, 생화학적 검사치, 임상병리학적 특성 등을 조사하였으며, 통계학적 검증으로 카이스퀘어 검정과 로지스틱 회귀분석을 실시하였다. 전체 조사대상자의 위암 재발률은 2.6%이었고, 성별 재발률은 남자에서 3.45%, 여자는 0.89%로 남자가 여자보다 약 4배정도 높았다. 단변량 로지스틱 회귀분석에서 재발이 발생할 위험은 림프전이가 있을수록 8.793배, 헬리코박터 파이로니균에 감염시 6.495배, 총콜레스테롤이 비정상일 때 14.333배 높았다. 다변량 로지스틱 회귀분석에서 림프전이와 헬리코박터 파이로니 감염이 재발에 중요한 요인으로 작용하였다. 결론적으로 위암의 재발에는 림프전이, 헬리코박터 파이로니 감염과 총콜레스테롤을 관리하고, CEA 및 CRP와 같은 생화학적 물질을 모니터링하여 재발을 조기에 발견하기 위한 노력이 함께 필요할 것으로 보인다.

Keywords

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