老年结肠癌根治术后复发转移Cox模型回归分析  

Cox regression analysis of recurrence and metastasis factors of colon cancer radical resection in elderly patients

作　　者：郭思佳[1] 刘行宇[1] 吴国松[1] 李慧婷[1] 赵璐[1] 李思文[1] 韩珩[2] 毛静馥[1] 

机构地区：[1]哈尔滨医科大学公共卫生学院,哈尔滨150001 [2]哈尔滨医科大学附属第二医院

出　　处：《实用肿瘤学杂志》2013年第6期504-508,共5页Practical Oncology Journal

基　　金：全国医疗卫生行业风险管理研究所科研计划项目（LHYLFXZD201202）

摘　　要：目的收集并分析2002年1月-2013年6月11年问209例行结肠癌根治术的老年患者的病理特征和手术情况，探讨影响术后复发转移的因素。方法采用Cox风险比例模型对患者的年龄、性别、病程、住院时长、手术医生经验、手术时长、是否为腹腔镜手术、肿瘤部位、肿瘤大小、肿瘤大体形态、分化程度、浸润深度、淋巴结转移和梗阻共计14个变量进行单因素和多因素分析，运用Kaplan—Meier法绘制患者术后复发转移生存曲线。结果单因素分析发现，肿瘤大小（RR：2．658，P〈0．0001）、大体形态（浸润型RR=3．407，P=0．0054）、分化程度（RR=0．32，P〈0．0001）与结肠癌根治术后复发转移有关，多因素分析结果显示，患者性别（RR=0．585，P=0．0359）、肿瘤大小（RR=2．364，P〈0．0001）、大体形态（浸润型RR=0．246，P=0．0437）、分化程度（RR=0．31，P〈0．0001）与结肠癌根治术后复发转移有关。结论患者性别、肿瘤大小、大体形态和分化程度是影响老年结肠癌根治术后复发转移的因素，对确定高危人群，进行有针对性的术后随访，提早发现和治疗有重要意义，有利于提高患者生活质量，延长患者生存时间，Objective To analyze the clinicopathologic data and operative parameters of 209 elderly co- lon cancer patients treated by radical resection between January 2002 and December 2011, and to investigate the factors related to recurrence and metastasis after colon cancer radical resection in elderly patients. Methods We used univariate and muhivariate analysis of Cox regression, including 14 variables ： age, gender, disease duration, hospitalization duration, surgeon experience, operation duration, laparoscopicsurgery, tumor location, tumor size, gross morphology, differentiate degree, depth of bowel wall invasion,lymph node involvement and obstruction. The survival curve was obtained by Kaplan - Meier method. Results Univariate analysis showed that tumor size（ RR = 2. 658 ,P 〈 0. 0001 ）, gross morphology （ Infiltrating type, RR = 3. 407, P = 0. 0054 ）, degree of differentiation （RR =0.32,P 〈 0. 0001 ）were associated with tumor relapse and metastasis. Multivariate analysis showed that gender（ RR = 0. 585, P = 0. 0359 ） , tumor size （ RR = 2. 364, P 〈 0. 0001 ） , degree of differentiation （ Infiltrating type, RR = 0. 246, P = 0.0437 ）, gross morphology （ RR = 0.31, P 〈 0.0001 ） were the significant factors. Conclu- sion Gender,tumor size, degree of differentiation, gross morphology were the independent facto~ of recurrence and metastasis of colon cancer after radical resection in elderly patients. Targeted follow - up for high - risk groups will improve patients＇ life quality and prolong their survival time.

关 键 词：结肠癌根治术 复发 转移 COX回归分析 

分 类 号：R735.3[医药卫生—肿瘤]