Dukes A、B期大肠癌术后复发及转移的危险因素分析  

Analysis of Risk of Postoperative Recurrence and Metastasis in Patients with Dukes' Stage A or B Colorectal Cancers

作　　者：张伟斌[1] 黄素娴[2] 洪楚源[2] 吴礼浩[3] 舒阳春[4] 何兴祥[3] 

机构地区：[1]广东药学院附属第一医院胃肠外科,广州市510080 [2]广州医学院第二附属医院胃肠外科 [3]广东药学院附属第一医院消化内科,广州市510080 [4]广东药学院附属第一医院肿瘤科,广州市510080

出　　处：《中华全科医学》2011年第5期681-681,760,共2页Chinese Journal of General Practice

基　　金：广东省高等学校高层次人才项目(粤教师函[2010]79号);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期及B期大肠癌术后局部复发或者远处转移的危险因素。方法对2000年2月-2003年2月间首次实施根治性手术的Dukes A期及B期者65例,随访至2008年2月。局部复发的诊断应用肠镜及病理检查,远处转移的诊断应用B超或CT检查。结果全组患者术后5年共3例局部复发,复发率4.8%(3/65)。6例发生肿瘤远处转移,转移率9.6%(9/65)。肿瘤部位(R=-0.257,P=0.039)及局部浸润深度(R=-0.339,P=0.006)与复发相关。肿瘤局部浸润深度(R=-0.255,P=0.04)、神经受累(R=0.251,P=0.044)、术后放疗(R=0.307,P=0.013)、术后化疗(R=-0.431,P=0.007)与肿瘤远处转移相关。结论较早期的大肠癌患者根治术后仍有复发或者转移的可能性,术后化疗可减小Duke B期大肠癌患者术后转移的发生。Objective To investigate the risk of postoperative recurrence and metastasis in patients with Dukes’ stage A or B colorectal cancers.Methods Sixty-five patients with Dukes’ Stage A or B Colorectal Cancer during Feb 2000-Feb 2003.were selected and followed up until 2008.2.Results Of all cases,3 endured postoperative recurrence,the rate was 4.8%（3/65）.Six cases suffered from postoperative metastases,the rate was 9.6%（9/65）.Rectal cancer（R=-0.257,P=0.039）,invasive depth（R=-0.339,P=0.006） were correlated with high risk of recurrence;depth（R=-0.255,P=0.04）,nerve involved（R=0.251,P=0.044）,post-operative radiotherapy（R=0.307,P=0.013）,and postoperative chemotherapy（R=-0.431,P=0.007） were correlated with high risk of Metastases.Conclusion Postoperative chemotherapy may be helpful for patients with stage B colorectal cancers by minimize the risk of metastasis

关 键 词：大肠肿瘤 肿瘤复发 肿瘤转移 预后 

分 类 号：R735.34[医药卫生—肿瘤] R73-37[医药卫生—临床医学]