肥胖与结直肠癌根治术后预后的关系  

Association of obesity and colorectal cancer after radical surgery

作　　者：向继红[1] 袁家天[1] 吕波[1] 范俊[1] 冷书生 张鑫[1] 李俊[1] 

机构地区：[1]成都大学附属医院普外科,610081

出　　处：《中华临床医师杂志（电子版）》2015年第24期27-31,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的研究肥胖与结直肠癌根治术后预后的关系。方法纳入成都大学附属医院2000年1月至2010年1月接受根治性手术的结直肠癌患者400例,回顾性分析肥胖与局部复发(LR)、远处转移(DM)以及5年无病生存率(5-year DFS)的关系。结果 BMI与患者年龄(P<0.001)、是否患糖尿病(P=0.020)以及肿瘤部位(P=0.016)有关。肥胖、年龄、术前CEA、肿瘤大小、肿瘤分化程度、p T分期、p N分期、癌结节、脉管瘤栓、术后放化疗是结直肠癌根治术后5年DFS的相关预后因素,正常组、超重组、肥胖组5年无病生存率分别为78.2%、62.1%和55.9%(P<0.001);组间比较显示3组之间5年DFS差异均显著(P均<0.05)。结论术前CEA、肿瘤分化程度、p T分期、p N分期、术后放化疗是直肠癌根治术后独立预后影响因子。肥胖是结直肠癌不良预后因素,但不是独立预后因素。ObjectiveTo evaluate the association between obesity and colorectal cancer after radical surgery.Methods400 patients with colorectal cancer from January 2000 to January 2010 underwent radical operation were included. Retrospectively analyzed the obesity and patients with local recurrence (LR), distant metastasis (DM), and 5-year of disease free survival (5-year DFS).ResultsBMI was correlated with age of the patients (P<0.001), diabetes (P=0.020) and tumor location (P=0.016). Age, preoperative CEA, tumor size, tumor differentiation, pT stage, pN stage, tumor deposits, vascular invasion, treatment after radiotherapy and chemotherapy were the prognostic factors of colorectal cancer after radical resection. 5-year DFS of normal group, overweight and obesity group were 78.2%, 62.1% and 55.9% (P<0.001); the comparison between groups showed that the 5-year DFS of three groups was significant (P<0.05), respectively. ConclusionPreoperative CEA, tumor differentiation, pT stage, pN stage, postoperative radiotherapy and chemotherapy were the independent prognostic factors for rectal cancer after radical resection. BMI is an adverse prognostic factor for colorectal cancer, but it is not an independent prognostic factor.

关 键 词：肥胖症 结直肠肿瘤 

分 类 号：R735.34[医药卫生—肿瘤] R589.2[医药卫生—临床医学]