结直肠印戒细胞癌62例外科手术预后相关因素分析  

Surgical Treatment and Prognosis of 62 Patients with Colorectal Signet-ring Cell Carcinoma(Analysis of Correlating Factors)

作　　者：张兵[1] 王宁[1] 

机构地区：[1]内蒙古医学院附属人民医院普外科,呼和浩特010020

出　　处：《临床误诊误治》2010年第5期425-427,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨结直肠印戒细胞癌外科治疗方法及影响预后的因素。方法回顾性分析我院1988年1月-2006年12月外科手术治疗的62例结直肠印戒细胞癌临床病理资料及随访情况,对随诊资料采用Kaplan-Meier法进行生存因素分析。结果 62例均因结直肠占位病变行手术治疗,其中33例行根治性肿瘤切除术,10例行姑息性肿瘤切除术,19例行剖腹探查或结肠造瘘术,全部经术后病理诊断为印戒细胞癌。术后37例行辅助化疗。本组55例获随访,中位生存期28个月,根治性肿瘤切除、姑息性切除、未手术切除患者的中位生存期分别为47、19、10个月,不同手术方式术后生存期比较差异具有统计学意义（P〈0.05）。多因素分析结果显示有无肠梗阻、手术方式、血管瘤栓、浸润深度、淋巴结转移和术后辅助治疗是影响结直肠印戒细胞癌预后的独立因素。结论结直肠印戒细胞癌预后较差,早期诊断予根治性切除术并结合术后辅助放化疗,可改善患者预后。Objective To explore correlating factors of surgical treatment and prognosis of colorectal signet-ring cell carcinoma.Methods Clinical pathological data and follow-ups were analyzed retrospectively in 62 patients with colorectal signet-ring cell carcinoma hospitalized during January 1988-December 2006.Survival genetic data were evaluated by the Kaplan-Meier methods.Results All the 62 patients underwent rectum surgeries（33 underwent radical resection;19 underwent colostomy or exploratory surgery and 10 underwent palliative resection,diagnosed as signet-ring cell carcinoma,37 of whom underwent postoperatived adjunctive chemotherapy and 55 patients in the group were followed up）.Median survival time was 28 months and the meta-survival time of radical incision,palliation incision and non surgical incision were 47,19,10 months respectively.The difference was of statistical significance（P0.05）.Regression analysis revealed that bowel obstruction,vessel tumor embolism,tumor infiltration,lymph node metastasis,operative modus and postoperative adjunctive therapy were independent prognostic factors.Conclusion Prognosis of colorectal signet-ring cell carcinoma tends to be unsatisfactory.Early diagnosis with radical resection and postoperative adjunctive therapy can improve prognosis.

关 键 词：结直肠肿瘤 肿瘤 印戒细胞 外科手术 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]