Dukes A、B期大肠癌术后总生存率及无瘤生存率分析  

Analysis of Survival Rate and the Disease Free Survival in Patients with Dukes' Stage A or B Colorectal Cancers

作　　者：袁瑜[1] 黄素娴[2] 洪楚源[2] 何兴祥[1] 

机构地区：[1]广东药学院附属第一医院消化内科,广州市510080 [2]广州医学院第二附属医院胃肠外科,510260

出　　处：《中华全科医学》2011年第1期5-6,107,共3页Chinese Journal of General Practice

基　　金：广东省自然科学基金(9251065005000001);广东省科技计划项目(2008A030201001)

摘　　要：目的探讨Dukes A、B期大肠癌术后总生存率及无瘤生存率,分析相关因素对预后影响。方法 2000年2月-2003年2月年间收治初发大肠癌病例,行首次根治术临床病理分期为Dukes A及B期者65例,术后采用门诊、电话、信访方式随访至2008年2月,以COX回归比例风险模型对预后进行相关因素分析。结果全组5年总生存率及无瘤生存率分别为89.6%及80.9%,其中Dukes A期病例总生存率及无瘤生存率均优于Dukes B期(P<0.01)。经过单因素分析提示与Dukes A、B期无瘤生存率相关因素包括年龄(P=0.008)、组织类型(P=0.025)、肿瘤大小(P=0.036)、肿瘤部位(P=0.040)、术后化疗(P=0.005)等,将以上差异有统计学意义的变量再进入COX风险比例模型行多因素分析,提示肿瘤浸润深度(Wald卡方=4.949,P=0.026)及远处转移(Wald卡方=3.995,P=0.046)是与无瘤生存率相关的独立性影响因素。结论肿瘤浸润深度、远处转移是影响Dukes A、B期大肠癌无瘤生存率的独立影响因素,随着肿瘤浸润深度的加深,术后辅助化疗可能有助于改善预后。Objective To investigate survival rate and the disease free survival in patients with Dukes＇ Stage A or B colorectal cancers and analyze the prognosis related factors. Methods Sixty-five patients with Dukes＇ Stage A or B colorectal cancer of 2000.2-2003.2 and follow-up visit to 2008.2 were enrolled. Cox ratio risk pattern analysis was used. Results The 5-year survival rate and the disease free survival rate of group were 89.6% and 80.9%. The survival rate and the disease free survival rate in Dukes＇ A was superior to that of Dukes＇ B （P 〈 0.01 ）. Univariate analysis showed that the relative factors of the disease free survival rate in Dukes＇ ＂A and Dukes＇ B were age （ P = 0. 008 ）, histological differentiation （ P = 0. 025 ）, tumor size （ P = 0. 036 ）, tumor location （ P = 0. 040）, chemotherapy （ P -- O. 005 ）. Multivariate analysis based on a COX proportional hazard model showed that invasive depth and metastasis were independent prognostic factors about the disease free survival rate of patients with Dukes＇ stage A or B colorectal cancers. Conclusion Invasive depth and metastasis were independent prognostic factors about the disease free survival rate of patients with Dukes＇ stage A or B colorectal cancers. Postoperative chemotherapy was helpful to patients.

关 键 词：大肠肿瘤 生存率 COX 

分 类 号：R735.34[医药卫生—肿瘤] R73-31[医药卫生—临床医学]