病理分期对新辅助治疗直肠癌患者预后的影响  

Effect of pathological staging of neoadjuvant therapy for prognosis of patients with rectal cancer

作　　者：阿娜尔古丽.阿布都热合曼 吾甫尔.吾拉木 丁剑冰[3] 迪丽努尔.阿西木 

机构地区：[1]新疆维吾尔自治区人民医院北院病理科,乌鲁木齐830000 [2]新疆维吾尔自治区人民医院北院普外科,乌鲁木齐830000 [3]新疆医科大学第一附属医院感染科,乌鲁木齐830011 [4]新疆维吾尔自治区人民医院病理科,乌鲁木齐830000

出　　处：《中华临床医师杂志（电子版）》2015年第14期18-21,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金(81060135)

摘　　要：目的探讨病理分期对新辅助治疗直肠癌患者预后的影响。方法回顾性分析2004年1月至2011年12月期间我院接受新辅助治疗+根治性手术治疗的152例中晚期直肠癌患者的临床资料和术后生存状况。采用Kaplan-Meier法计算各亚组3年无病生存率(DFS),并用Log-rank检验进行比较。采用单因素和多因素Cox比例风险回归模型进行预后分析。结果全部患者的3年DFS为84.3%。T、N分期、淋巴结转移率、局部浸润因素、术前CEA、CA19-9水平的各亚组之间的3年DFS比较,差异有统计学意义(P<0.05)。N分期、淋巴结转移率、局部浸润因素和术前CEA水平是影响直肠癌患者预后的独立影响因素(P<0.05)。结论直肠癌新辅助治疗后仍然推荐进行手术治疗,术后病理分期与患者的预后密切相关,其中N分期、淋巴结转移率、局部浸润因素是其独立影响因素。Objective To investigate the effect of pathological staging of neoadjuvant therapy for prognosis of patients with rectal cancer. Methods Clinical data and postoperative survival status of 152 patients with advanced rectal cancer who received neoadjuvant therapy ＋ radical surgical treatment in our hospital from January 2004 to December 2011 were retrospectively analyzed. Kaplan-Meier method was used to calculate 3-year disease-free survival （DFS） of each sub-group, and Log-rank test was performed to compare. Univariate and multivariate Cox proportional hazard regression model were used to prognosis analysis. Results All patients＇ 3-year DFS was 84.3%. There were significant differences in 3-year DFS among sub-groups of T, N stage, lymph node metastasis rate, local infiltration factor, preoperative CEA, CA19-9 levels （P〈0.05）. N stage, lymph node metastasis rate, local infiltration factor and preoperative CEA level were independent prognostic factors of patients with rectal cancer. Conclusions Operation is still recommend for patients with rectal cancer after neoadjuvant therapy. Postoperative pathological staging is closely related with prognosis, and N stage, lymph node metastasis rate, local infiltration factor are independent related factors.

关 键 词：肿瘤分期 直肠肿瘤 肿瘤辅助疗法 

分 类 号：R735.37[医药卫生—肿瘤]