结肠腺癌的临床病理特征及预后分析  

The clinicopathological features of colon adenocarcinoma and the prognostic analysis

作　　者：赵晓丽[1] 岳常丽[1] 徐仟[1] 刘红刚[1] 金玉兰[1] 

机构地区：[1]首都医科大学附属北京同仁医院头颈部分子病理诊断北京市重点实验室,北京100730

出　　处：《中国医刊》2016年第4期42-47,共6页Chinese Journal of Medicine

摘　　要：目的探讨结肠腺癌的临床病理特征及部分临床病理参数与肿瘤预后的相关性。方法回顾性分析北京同仁医院病理科于2011年2月至2015年2月期间的111例结肠腺癌患者的临床病理特征,并结合患者随访资料行临床病理学参数与预后关系分析。结果 111例患者中,男女比例为55：56,年龄30～87岁,中位年龄68岁。研究发现远处转移与淋巴结转移存在显著相关性（P〈0.05）;淋巴结转移、肿瘤分化、临床分期和远处转移与死亡率呈显著正相关（P〈0.05）;Cox回归分析结果显示,有淋巴结转移发生远处转移的风险为无淋巴结转移患者的3.161倍（95%置信区间：0.875～11.415）;临床分期Ⅰ、Ⅱ、Ⅲ相对于Ⅳ期患者,远处转移发生风险分别为0.000、0.000、0.035;有淋巴结转移发生死亡风险为无淋巴结转移患者的5.867倍（95%置信区间：0.725～47.447）;高分化、中分化相对于低分化腺癌患者,死亡发生风险分别为0.138（95%置信区间：0.027～0.715）、0.679（95%置信区间：0.129～3.562）;临床分期Ⅰ、Ⅱ、Ⅲ相对于Ⅳ期患者,死亡发生风险分别为0.000、0.069、0.158。结论淋巴结转移、临床分期和肿瘤分化与结肠腺癌的死亡有密切相关,淋巴结转移和临床分期可能与肿瘤远处转移相关。年龄、性别、肿物大小、浸润深度在肿瘤的远处转移及死亡中无显著影响。Objective To investigate the clinicopathological features of colon adenocarcinoma and the correlation between some clinicopathological parameters and the prognosis. Method To retrospectively analyze the clinicopathological features of 111 colon adenocarcinoma specimens from February 2011 to February 2015 in Beijing Tongren Hospital. The correlation between clinicopathological features and the prognosis were also analyzed according to the follow-up material. Result In all 111 patients, the malt-female ratio was 55：56 and the age range was 30～87, while the median age was 68.0. A significant correlation was detected between the distant metastasis and the lymphatic metastasis（P〈0.05）. A positive correlation existed between the death incidence and the lymphatic metastasis, the tumor differentiation as well as the clinical stage（P〈0.05）. The cox regression analysis showed that the risk of death in patients with lymphatic metastasis was 3.161 times as high as that in those patients without lymphatic metastasis [95%confidence interval（CI）： 0.875～11.415]. The risks of distant metastasis in patients with clinical stage Ⅰ, Ⅱ and Ⅲ were 0.000, 0.000 and 0.035 as compared to patients with clinical stage Ⅳ. The risk of death in patients with lymphatic metastasis was 5.867 times as high as that in those patients without lymphatic metastasis（95%CI： 0.725～47.447）. In comparison with patients with low differentiation, the risks of death in patients with high and moderate differentiation were 0.138（95%CI： 0.027～0.715） and 0.679（95%CI： 0.129～3.562）. The risks of death in patients with clinical Ⅰ, Ⅱ and Ⅲ stage were 0.000, 0.069 and 0.158 as compared to that in patients with clinical stage Ⅳ. Conclusion The lymphatic metastasis, the clinical stage and the tumor differentiation correlated with the death in patients with colon adenocarcinoma, while there was a close correlation between the distant metastasis and the lymphatic metastasis as well as the clinical stage. Howev

关 键 词：结肠肿瘤 腺癌 病理学 预后 

分 类 号：R730.261.1[医药卫生—肿瘤] R322.452[医药卫生—临床医学]