结直肠癌患者临床病理特征及预后的影响因素研究  

Colorectal Cancer: Clinicopathological Characteristics and Prognostic Factors

作　　者：徐伟[1,2] 宋志刚 丁红[1] 刘亚巍[2] 戴广海 

机构地区：[1]解放军总医院肿瘤内二科,北京100853 [2]联合参谋部警卫局卫生保健处,北京100017 [3]解放军总医院病理科,北京100853

出　　处：《现代生物医学进展》2017年第34期6692-6696,共5页Progress in Modern Biomedicine

摘　　要：目的:探讨结直肠癌患者的临床病理特征和预后影响因素,为结直肠癌的防治提供理论参考。方法:回顾性研究2007年1月至2011年12月在解放军总医院外科手术切除并经病理组织学检查证实的964例结直肠癌患者。根据肠的分布部位将结直肠癌患者分为直肠组(502例)、横结肠组(58例)、降结肠组(213例)和升结肠组(191例)。通过免疫组织化学法检测内切修复交叉补体1(ERCC1)和胸苷酸合酶(TS)的表达。采用卡方检验评估四组患者之间临床特征是否存在差异。Cox比例风险回归模型分析结直肠癌患者预后的影响因素。结果:年龄、肿瘤大小、肿瘤分化程度、原发性肿瘤和ERCC1表达在四组之间差异均有统计学意义(P<0.05)。与其他三组比较,ERCC1和TS在升结肠组中的阳性表达率最高。Cox回归分析发现,ERCC1表达(HR=0.318,P<0.001)是结直肠癌患者预后的独立影响因素。结论:ERCC1高表达患者相对于低表达患者预后更差,ERCC1可能成为结直肠癌新的预后标志物。Objective： To investigate the clinicopathological features and prognostic factors of colorectal cancer patients,and to provide theoretical reference for the prevention and treatment of cancer patients. Methods： A total of 964 patients with colorectal cancer, who were performed surgical resection and confirmed by histopathological examination in the People＇s Liberation Army General Hospital from January 2007 to December 2011, were retrospectively studied. The colorectal cancer patients were further divided into rectum group （502 cases）, transverse colon group （58 cases）, descending colon group （213 cases） and ascending colon group （191 cases） according to the location of the bowel distribution. Expression of excision repair cross-complementing group 1 （ERCC1） and thymidylate synthase （TS） were examined by immunohistochemistry. The chi-square test was used to assess whether there were differences in the clinical characteristics among the four groups. Cox proportional hazards regression model was used to analyze the prognostic factors of colorectal cancer patients. Results： The age, tumor size, tumor differentiation, primary tumor and ERCC1 expression were statistically significant among the four groups （P〈0.05）. Compared with other three groups, the positive expression rates of ERCC1 and TS in ascending colon group were the highest. Cox regression analysis showed that ERCC1 expression （HR=0.318, P〈0.001） was an independent prognostic factor in colorectal cancer patients. Conclusion： The patients with high ERCC1 expression have worse prognosis than those with low ERCClexpression. ERCC1 may be a new prognostic marker for colorectal cancer.

关 键 词：结直肠癌 临床特征 内切修复交叉补体1 胸苷酸合酶 预后 

分 类 号：R735.3[医药卫生—肿瘤]