【作者】 刘伯涛；

【导师】 于健春； 周立； 康维明； 马志强；

【作者基本信息】 北京协和医学院 ， 临床医学， 2010， 博士

【摘要】 目的：本研究探讨CDK2表达与胃癌临床、病理特点及预后的关系。方法：收集2002年6月至2003年1月间行手术治疗的67例胃癌标本,采用免疫组织化学方法检测CDK2的表达情况,并评价癌组织与癌旁组织CDK2表达与患者临床病理以及预后的相关性。结果：胃癌组织和癌旁组织CDK2的表达率分别为77.6%、58.2%,存在差异,P=0.026。CDK2表达率在患者临床病理特点各组间无差异。癌组织CDK2表达率在患者的总体生存和无瘤生存组间无差异。TNM分期较早的患者与分期较晚的在生存期及无瘤生存期水平存在差异,P<0.05。结论：CDK2在胃癌癌组织的表达率较癌旁组织明显增高,提示CDK2表达与胃癌的发生有关；未发现癌组织CDK2表达与患者的临床病理、总体生存和无瘤生存有关；TNM分期是决定胃癌患者预后的重要因素。目的：应用NRS-2002营养风险筛查评分,研究胃癌患者营养风险的发生率,并探讨营养风险同营养支持应用情况及卫生经济学指标的关系。方法：采用前瞻性研究方法,对2008年10月至2010年4月期间基本外科入院的胃癌患者进行NRS-2002营养风险筛查,并记录营养支持应用情况及卫生经济学相关指标。结果：胃癌营养风险发生率(NRS2002评分大于或者等于3分)62.8%,其中高风险(评分3-4分)18.8%,低风险(评分5-7分)43.9%,老年患者(年龄大于或者等于65岁)营养发生率86.0%。老年患者药品费用明显高于非老年患者,P=0.016。有营养风险患者住院时间、医疗费用,明显高于无营养风险患者,P值均<0.05；评分为高风险患者医疗费用明显高于低风险患者,P值<0.05。有营养风险患者,尤其老年患者,术前营养支持其住院时间、医疗费用明显低于无营养支持者,P值均<0.05。结论：胃癌患者营养风险发生率为62.8%,其中以老年患者尤为明显(86.0%)；有营养风险患者,医疗花费和住院时间增高,尤其高风险患者；有营养风险患者,尤其老年患者术前营养支持可减少住院时间和医疗花费；术前营养支持能使有营养风险患者,尤其是老年患者和高风险受益。更多还原

【Abstract】 Objective:To evaluate correlations between CDK2expression and patients’ clinicopathological factors and prognosis in gastric cancer.Methods:A total of67patients with gastric cancer underwent surgical resection from Jun2002to Jan2003were included. Expression of CDK2in tumor and para-tumor tissues was determined by immunohistochemistry. The relationship between CDK2expression and clinicopathological and prognostic variables were evaluated.Results:The expression ratios of CDK2in tumor and para-tumor tissues were77.6%and58.2%,statistical difference in them, P=0.026. The expression of CDK2in tumor tissues and para-tumor tissues has no ralationship with clinicopathological characteristic. Univariate analysis showed that patients with negative CDK2expression in tumor tissues had no significantly prolonged overall and tumor-free survival, compared with those with positive expression. TNM stage was correlated with patient prognosis, patients of an early stage had a significantly prolonged overall and tumor-free survival, compared with those of a later stage.Conclusions:Our data demonstrated that the expression of CDK2in tumor tissues is higher than para-tumor tissues. The finding indicated that CDK2might be involved in tumorigenesis of gastric cancer. Second, CDK2was not correlated with clinicopathological variables and patient prognosis. Finally, TNM stage was important for patient prognosis. Objective:The aim of this study was to evaluate the rate of nutrition risk in patients with gastric cancer by NRS-2002, to assess the correlations between nutrition risk and applications of nutrition support and health economical indexes.Methods:In this prospective study, patients in general surgery department were included from Oct2009to Apr2010. Patients received nutrition risk screening2002at the admission. Data aslo was recorded on applications of nutrition support and health economical indexes.Results:The average rate of nutrition risk in gastric cancer was62.8%, including high risk18.8%, low risk43.9%. The rate in elderly patients was86.0%. The drug expenses of elderly patients was different to not elderly, P=0.016. The hospitalized time and medical expenses were different between patients with and without nutrition risk, P<0.05, and there existed a difference of medical costs between high risk patients and lower risk, P<0.05. Compared with those without preoperation nutrition support, hospitalized time and medical expenses at nutrition risk showed a difference in patients received nutrition support, especially for elderly ones, P<0.05.Conclutions:Patients with gastric cancer, especially elderly ones, had a high rate of nutrition risk. Those with nutrition risk had higher hospitalized time and medical expenses especially high risk patients. For patients, especially elderly and high risk ones with nutrition risk, the preoperative nutritional support could reduce the time and the expenses.更多还原