结直肠癌根治术Cox模型预后分析  

Multivariate Analysis of Prognosis of Radical Resection for Colorectal Carcinoma

作　　者：潘志忠[1] 万德森[1] 张昌卿[1] 冯海涛 邵建永[1] 詹友庆[1] 周志伟[1] 陈映波[1] 陈功[1] 

机构地区：[1]中山医科大学肿瘤医院,510060

出　　处：《广东医学》1998年第11期822-822,共1页Guangdong Medical Journal

摘　　要：目的：对172例结直肠癌根治术患者进行预后分析，旨在发现影响预后的临床及分子生物学因素，探索提高其疗效的措施。方法：用LSAB免疫组化方法检测p53、PCNA，用Cox模型分析可能影响预后的21个因素。结果：全组5年生存率为74．2％，其中结肠癌85.8％，直肠癌66．8％，p53蛋白阳性率43．6％（75／172），PCNA阳性率91．3％（157／172）。多因素分析显示，术后复发、转移和p53蛋白积聚是影响预后最重要的三个因素。结论：p53蛋白阳性是预后差的生物学标志，术后复发、转移是治疗失败的主要原因。综合治疗措施是减少术后复发、转移，提高生存率的有效手段。Objective: to find the clinicopathologic and molecular biological factors. which would affect the prognosis ,andeffective treatments, Cox proportion harzd model were used to analyse the prognosis of 172 cases of radical resection for colorectal carcinoma. Methods: p53 protein and porliferating cell nuclear antigen(PCNA)were examined immunohistochemistrically by LSAB method, a total of 21 factors which would affect the results of radical resection for colorectal cancer were analysed by Cox proportion harzd model .Results: The 50year=surival rate was 74.2% in total, of those ,85.8% in colon cancer, and 66.8% in rectal cancer respectively .P53 and PCNA immunohistochemistrical positive-rate were 43.6%(75/172),91.3%(157/172)respectively. Multivariate analysis showed that recurrence. metastasis, and p53 were the most important prognositic factros. Conclusions: The failure of treatment mainly resulted rom recurrence and metastasis .Multimodel treatments could keep the patients from recurrence and metastasis, and improve their survival rate. Furthemore, p533 protein was a biologice marker of colorectal cancer with higher grade malignancy and poor progrosis. Mutant p53 gene would be one of the key targets of effective treatments.

关 键 词：预后 统计学 COX模型 结直肠癌 根治术 

分 类 号：R735.34[医药卫生—肿瘤]