结肠癌患者预后临床病理的多因素分析  

Multivariate analysis of prognostic factors for patients with colon carcinoma

作　　者：张宝昕 潘宏达[2,3,4] 高兆亚 顾晋[2,3,4] 赵军[2,3,4] 

机构地区：[1]河北省沧州中西医结合医院,河北省沧州市061001 [2]北京大学肿瘤医院 [3]北京肿瘤医院 [4]北京市肿瘤防治研究所结直肠肿瘤外科 恶性肿瘤发病机制及转化研究教育部重点实验室,北京市100142

出　　处：《世界华人消化杂志》2014年第15期2202-2207,共6页World Chinese Journal of Digestology

摘　　要：目的:探讨影响结肠癌患者术后生存的临床病理因素.方法:回顾性分析2007-07/2010-05北京肿瘤医院结直肠外科手术治疗的结肠癌患者临床病理资料,对可能影响患者生存的因素进行单因素和Cox多因素模型分析.分析影响结肠癌预后的因素.结果:(1)全部患者3年总生存率为81.9%;(2)单因素分析发现术前血清癌胚抗原(carcino-embryonic antigen,CEA)水平>5 ng/mL、肿瘤分化程度低、年龄<40岁、更高的T分期、N分期、M分期、术中输血和脉管癌栓(P<0.05是影响患者预后的因素;(3)多因素回归分析术前血清CEA水平(P=0.017)、肿瘤分化程度(P=0.002)、N分期(P=0.005)M、分期(P=0.000)是患者生存的独立预后危险因素.结论:根据术前血清CEA水平、肿瘤分化程度、更高N分期、有无远处转移可以对结肠癌具有预后不良因素的患者进行更准确的风险分层,针对此类高危患者临床上应采取更积极的治疗以及术后更加密切的随访.AIM： To investigate the prognostic factors for colon carcinoma by analyzing its clinical and pathological characteristics. METHODS： We retrospectively reviewed the demographic, clinical, histopathological, and laboratory data for consecutive patients with colon cancer who underwent curative surgery alone from July 2007 to May 2010 at Peking University Cancer Hospital. Unvaried and multivariate analyses were conducted to identify prognostic factors for colon carcinoma. RESULTS： A total of 226 valid cases were re- viewed in this study, and their 3-year overallsurvival rate was 81.9%. Univariate analysis showed that preoperative CEA level 〉 5 ng/mL, poor differentiation, age 〈 40, blood transfusion, higher T stage, higher N stage, metastasis and lymphatic vessel invasion were poor prognostic factors for patients with colon cancer （P 〈 0.05）. Multivariate analysis found that preoperative CEA level （P = 0.017）, higher N stage （P = 0.005）, poor differentiation （P = 0.002）, and higher M stage （P = 0.000） were the independent prognostic factors for colon carcinoma. CONCLUSION： Based on the prognostic risk factors such as preoperative CEA level poor differentiation, higher N stage and metastasis, more accurate risk stratification can be conducted in patients with colon cancer. Patients with such risk factors should be considered as candidates for receiving more intensive treatment and surveillance.

关 键 词：结肠癌 预后 多因素分析 

分 类 号：R735.35[医药卫生—肿瘤]