比较Borrmann Ⅳ型与其他分型进展期胃癌的临床诊断及病理特点，探讨影响Borrmann Ⅳ型胃癌患者预后的因素。

回顾性队列分析首都医科大学附属北京友谊医院2013年1月至2021年1月收治的612例进展期胃癌手术患者，比较80例（13.1%）Borrmann Ⅳ型和532例（86.9%）其他Borrmann分型胃癌患者的临床诊断及病理特点，Kaplan-Meier法描绘生存曲线，采用Cox比例风险模型进行单因素和多因素分析。

Borrmann Ⅳ型胃癌患者在年龄、胃肠道肿瘤家族史、手术方式、R0切除、肿瘤最大径、瘤体面积、肿瘤部位、组织病理类型、分化程度、浸润深度、淋巴结转移、TNM分期与其他Borrmann分型相比，差异均有统计学意义（均P<0.05）。Borrmann Ⅳ型胃癌的腹盆平扫增强CT、胃镜肉眼诊断准确性分别为80.0%、81.2%，低于其他Borrmann分型的91.4%、91.8%（均P<0.05）。Borrmann Ⅳ型胃癌的胃镜首次病理活检阳性率为72.5%，明显低于其他Borrmann分型的93.7%（P<0.05）。上消化道造影对两组的诊断水平差异无统计学意义（96.2% vs 91.9%，χ²=0.593，P=0.701）。单因素和多因素分析显示，手术方式、肿瘤分布范围、脉管浸润及是否规范化疗是Borrmann Ⅳ型胃癌的独立预后因素（均P<0.05）。

Borrmann Ⅳ型胃癌具有独特的临床病理特征，需要采用多种检查手段鉴别，手术方式、肿瘤分布范围、脉管浸润及是否规范化疗是Borrmann Ⅳ型胃癌的重要预后因素。

To compare the clinicopathological and diagnositic features of Borrmann typeⅣ gastric cancer (GC) with other advanced GC and explore prognostic factors of the patients with Borrmann type Ⅳ GC.

A retrospective cohort analysis was performed in 612 patients undergoing surgery for advanced GC who were admitted to Beijing Friendship Hospital Capital Medical University from January 2013 to January 2021. The clinical diagnosis and pathological features of 80 patients (13.1%) with Borrmann typeⅣ and 532 patients (86.9%) with other Borrmann types of GC were compared. Kaplan-Meier method was used to describe the survival curve, and Cox proportional hazard model was used to analyze the univariate and multivariate survival.

There were statistically significant differences in age, family history of gastrointestinal tumor, surgical method, R0 resection, maximum tumor diameter, tumor area, tumor site, histopathological type, degree of differentiation, depth of invasion, lymph node metastasis and TNM stage among GC patients with Borrmann type Ⅳ compared with other Borrmann types (all P<0.05). The diagnostic accuracy rates of enhanced CT scan and visual gastroscopy of Borrmann type Ⅳ GC were 80.0% and 81.2% respectively, lower than 91.4% and 91.8% of other Borrmann types (all P<0.05). The positive rates of first gastroscopic biopsy of Borrmann type Ⅳ GC were 72.5%, which was significantly lower than 93.7% of other Borrmann types (P<0.05). There was no significant difference in the diagnostic level of upper gastrointestinal tract angiography between the two groups (96.2% vs 91.9%, χ²=0.593, P=0.701). Univariate and multivariate analysis showed that surgical method, tumor distribution, vascular invasion and whether to regulate chemotherapy were independent prognostic factors for GC patients with Borrmann typeⅣ (all P<0.05).

Borrmann type Ⅳ GC has unique clinicopathological characteristics, which requires multiple examination methods for identification. Surgical method, tumor distribution, vascular invasion and whether to regulate chemotherapy are important prognostic factors for Borrmann type Ⅳ GC.