结肠癌根治术后预后因素分析  

A Retrospective Analysis of Prognostic Factors for Colon Cancer Patients Who Underwent Radical Resection

作　　者：方红艳[1] 赵德英[1] 李湘浪 周福祥[1] 周云峰[1] 

机构地区：[1]武汉大学中南医院放化疗科/湖北省肿瘤医学临床研究中心,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2016年第3期440-444,共5页Medical Journal of Wuhan University

摘　　要：目的:探讨结肠癌根治术后影响患者预后的因素。方法:对2005年1月-2010年1月行结肠癌根治术的165例患者进行回顾性分析,采用Kaplan-Meier法计算患者的生存率,用Log-Rank检验比较组间生存率,应用Cox模型进行预后的多因素分析。结果:单因素分析显示:TNM分期、N分期、术前有无肠梗阻或穿孔、术前癌胚抗原(CEA)水平对无瘤生存时间(DFS)有显著影响(P<0.05),TNM分期、N分期、分化程度对总生存时间(OS)有显著影响(P<0.05),Cox多因素回归分析显示:N分期(P<0.01,HR=2.303)、术前CEA水平(P<0.05,HR=2.630)是DFS的独立影响因素,TNM分期(P<0.01,HR=3.035)、分化程度(P<0.05,HR=1.798)是OS的独立影响因素。Ⅲ期患者辅助化疗对DFS和OS均有统计学差异。结论:N分期和术前CEA水平是DFS的独立影响因素,TNM分期、分化程度是OS的独立影响因素。早诊早治、对于淋巴结阳性的患者应加强术后辅助化疗是改善预后的关键。Objective：To investigate the prognostic factors following radical resection.Methods：A total of 165 patients with colon cancer who underwent radical resection from January 2005 to January2010were retrospectively analyzed.Kaplan-Meier method was applied to analyze survival rates,and Log-rank test was performed to assess statistical significance among these groups.Cox proportional hazard analysis was used to evaluate the survival status of these patients.Results：Univariate analysis indicated that there was a significant variation in statistics of TNM stage,N stage,obstruction or enterobrosis before operation and CEA before operation for disease-free survival（DFS）（P〈0.05）.There was a significant variation in statistics of TNM stage,N stage and the differentiation extent for overall survival（OS）（P〈0.05）.Multivariate cox model analysis showed that N stage（P〈0.01,HR=2.303）and CEA before operation（P〈0.05,HR=2.630）were related to DFS.TNM stage（P〈0.01,HR=3.035）and the differentiation extent（P〈0.05,HR=1.798）were related to OS.Conclusion：N stage and CEA before operation are the independent prognostic factors of DFS for colon cancer patients following radical resection.TNM stage and the differentiation extent are independent prognostic factors of OS for colon cancer patients following radical resection.Early detection,management and adjuvant chemotherapy for node-positive patients play important roles in improving prognosis.

关 键 词：结肠肿瘤 生存分析 预后 

分 类 号：R735.3[医药卫生—肿瘤]