972例结肠癌患者预后多因素分析  

The prognostic factors in patients of colonic carcinoma

作　　者：唐元新[1] 李晓霞[1] 逯晓波[2] 

机构地区：[1]中国医科大学附属第四医院胃肠外科,沈阳110032 [2]中国医科大学公共卫生学院

出　　处：《中华普通外科杂志》2010年第3期189-192,共4页Chinese Journal of General Surgery

基　　金：辽宁省教育厅高等学校科研基金资助项目（2008781）;辽宁省自然科学基金资助项目（20062053）

摘　　要：目的通过对972例结肠癌患者临床病理等因素的分析，探讨影响结肠癌患者术后生存的因素。方法对972例结肠癌患者的临床资料进行单因素及多因素COX回归分析，生存率采用寿命表法计算，生存率的比较采用Log-rank检验法。结果单因素分析表明，年龄、围手术期输血、术前血清CEA（癌胚抗原，carcinoembryonic antigen）水平、肿瘤大体类型、肿瘤浸润深度、淋巴结转移、肝转移、其他脏器转移、肿瘤局部复发、腹膜种植、病理类型、TNM分期及淋巴结廓清术式均为影响预后的因素。多因素回归分析表明，年龄、术前血清CEA水平、肿瘤大体类型、淋巴结转移、肝转移、其他脏器转移、肿瘤局部复发、腹膜种植、病理类型、淋巴结廓清术式以及TNM分期是影响患者术后生存的独立因素。结论淋巴结转移是影响结肠癌患者预后最重要的因素。Objective To investigate the prognostic factors by analyzing clinicopathological characteristics of 972 cases of colonic carcinoma. Methods Clinical and pathological data of 972 patients with colonic carcinoma treated surgically were studied by univariate and multivariate analysis, survival rate was calculated by life-table method and compared by Log-rank test. Results The univariate analysis indicated that the predictors of survival were age, perioperative blood transfusion, perioperative carcinoembryonic antigen （CEA） level, tumor gross type, depth of tumor invasion, lymphatic invasion, liver metastasis, extrahepatic metastasis, local recurrence, peritoneal seeding, pathological type, TNM stage and type of lymph node clearance. The multivariate analysis indicated that the independent predictors of suivival were age, perioperative CEA level, tumor gross type, lymphatic invasion, liver metastasis, extrahepatic metastasis, local recurrence, peritoneal seeding, pathological type, type of lymph node clearance and TNM stage. Conclusions Lymphatic invasion is the most important independent prognostic factor of patients with colonic carcinoma treated surgically.

关 键 词：结直肠肿瘤 存活率 预后 因素分析 统计学 

分 类 号：R735.3[医药卫生—肿瘤]