结直肠癌肝转移患者临床预后分析  

The analysis of prognostic factors for liver metastasis from colorectal cancer

作　　者：艾克热木.玉苏甫[1] 帕尔哈提.沙依木 王海江[1] 拜里克孜.胡吉 

机构地区：[1]新疆医科大学附属肿瘤医院胃肠外科,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2009年第9期1292-1294,共3页Journal of Xinjiang Medical University

摘　　要：目的:探讨影响结直肠癌肝转移病人生存率的临床预后因素。方法:分析新疆医科大学附属肿瘤医院1997～2002年间诊治的结直肠癌肝转移病人88例临床资料,选择性别、年龄、血型、原发肿瘤大小、组织类型、治疗方式、T分期(肠壁浸润深度)、N分期(淋巴结转移情况)、癌胚抗原(CEA)、转移灶大小、转移灶数目等临床因素,寿命表法计算生存率,用Cox比例风险模型(SPSS 13.0统计软件)进行多因素分析。结果:单因素分析显示,治疗方式、原发灶大小、T分期、N分期等为预后影响因素(按α=0.1水平),多因素分析均显示,仅治疗方式、T分期为影响结直肠癌肝转移预后的重要因素。所有病例总的1、3、5年累计生存率分别为88.6%、12.9%、0%。单纯外科治疗组(31.8%)、综合治疗组(45.5%)及单纯辅助治疗组(9.1%)与未治组(13.6%)比较,1年、3年生存率有显著差异(P均<0.05)。结论:综合治疗方式为结直肠癌肝转移患者预后的独立保护性因素,可延长患者生存期;T分期是独立的预后危险因素。T分期越大,预后越差。Objective： To explore the clinical prognostic factors that influence the survival rate of patients with liver metastasis from colorectal cancer and analyze the significance of the these factors. Methods：Clinical and pathological data of 88 patients with liver metastasis from colorectal carcinoma diagnosed and treated from 1997 to 2002 in Xinjiang Tumor Hospital were collected in this study. Single and multifactor analysis were used to determine the prognostic factors concerned by cox regression （SPSS 13.0 for windows）. Results： T grade （infiltratingdepth）, N grade （lymph node metastasis）, tumor size of colorecum were the predictors of survival by Univariate analysis. Only therapeutic methods and T grade were significant prognostic factors by multivariate analysis. The 1, 3 and 5-year overall survival rates were 88.6%, 12.9%, 0% respectively. The 1 and 3-year overall survival rates of single operation group （31.8%）, comprehensive management group （45.5%） and single adjectivetherapy group （9. 1%） were significantly higher than those of nontherapy group（13.6%） （P 〈0.05）. Conclusions：comprehensive method for treatment of liver metastasis of colorectal cancer was the effective means of prelonging the survival time. T grade was independent risk factor of prognosis.

关 键 词：结直肠肿瘤 肝转移 预后 生存率 

分 类 号：R735.3[医药卫生—肿瘤]