转移淋巴结比例和转移淋巴结数量对结肠癌患者预后影响的比较  

Comparison of the effect of the ratio and quantity of metastasis lymph nodes on the prognosis of colon cancer patients

作　　者：苏晓文[1] 邓建中[1] 梁伟成[1] 苏国森[2] 李维[3] SU Xiao-wen1, DENG Jian-zhong1, LIANG Wei-cheng1, SU Guo-sen2, LI Wei3(1. Department of Gastrointestinal Surgery II; 2. Department of Oncological Surgery I; 3. Department of Oncological Surgery II, Gaozhou People＇s Hospital, Gaozhou 525200, Chin)

机构地区：[1]广东省高州市人民医院胃肠外二科,广东高州525200 [2]广东省高州市人民医院肿瘤外一科,广东高州525200 [3]广东省高州市人民医院肿瘤外二科,广东高州525200

出　　处：《广东医科大学学报》2017年第5期518-521,共4页Journal of Guangdong Medical University

摘　　要：目的比较转移淋巴结比例和转移淋巴结数量对结肠癌患者预后的影响。方法收集81例结肠癌患者的性别、年龄、肿瘤位置、肿瘤分化程度、切除标本总淋巴结数量、转移淋巴结数量和比例、复发时间和生存时间等资料。根据复发时间和生存时间应用Kaplan-Meier方法计算各分组的无病生存率和总生存率,并应用Log-Rank方法作比较。接着应用Cox比例风险模型,对患者的性别、年龄、肿瘤位置、病理分化程度、LNM和LNR与患者的无病生存率和总生存率进行多因素相关分析。结果根据转移淋巴结比例分组分析患者的无病生存率和总生存率时,各组之间差异较根据转移淋巴结数量分组进行分析时的更显著。Cox比例风险模型单因素分析发现性别和肿瘤位置与患者的总生存率和无病生存率无关(P>0.05),年龄、病理分化程度、淋巴结转移数量和淋巴结转移比较则与患者的总生存率和无病生存率明显相关(P<0.05)。而多因素分析则显示年龄、病理分化程度和转移淋巴结比例为影响患者总生存率和无病生存率的独立因素(P<0.05)。转移淋巴结数量则与其他因素相关,不是独立影响因素(P>0.05)。结论对中国结肠癌患者,转移淋巴结比例预测患者的预后优于转移淋巴结数量。Objective To compare the effect of the ratio and quantity of metastasis lymph nodes on the prognosis of colon cancer patients. Methods The clinical data （gender, age, tumor location, tumor differentiation grade, total number of metastasis lymph nodes, the quantity and ratio of metastasis lymph nodes, recurrence time and overall survival time） of 81 colon cancer patients were collected. Based on ratio and quantity of metastasis lymph nodes, overall survival rate and diseasefree survival rate were estimated by Kaplan-Meier method, and the difference was analyzed by Log-rank test. Next, for the determination of the relation between clinical data （gender, age, tumor location, tumor differentiation grade, the number of metastasis lymph nodes and metastasis lymph nodes ratio） and survival rate, a Cox proportional hazards model was used for multivariate analysis. Results The difference of survival rate analyzed based on the ratio of metastasis lymph nodes was more significant compared with that analyzed based on the quantity of metastasis lymph nodes. The univariate analysis showed that the gender and tumor location were uncorrelated to survival rate （P〉0.05）, and the age, tumor differentiation grade, the quantity and ratio of metastasis lymph nodes were correlated to survival rate （P〈0.05）. The multivariate analysis showed that the age, tumor differentiation grade, and the ratio of metastasis lymph nodes were independent prognostic factors （P〈0.05）, and the quantity of metastasis lymph nodes is not an independent prognostic factor （P〉0.05）. Conclusion For the patients with colon cancer, those with a prediction with the ratio of metastasis lymph nodes have a better prognosis compared with those with a prediction with the quantity of metastasis lymph nodes.

关 键 词：COX比例风险模型 结肠癌 预后 淋巴结转移 

分 类 号：R735.35[医药卫生—肿瘤]