T1期直肠癌淋巴结转移危险因素分析  

Risk factors of lymph node metastasis in T1 rectal cancer

作　　者：叶州 王默进[1] 白丽芬[1] 张鹏[1] 庄瀚翔 庄文[1] YE Zhou;WANG Mojin;BAI Lifen;ZHANG Peng;ZHUANG Hanxiang;ZHUANG Wen(Department of Gastrointestinal Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西医院胃肠外科中心,成都610041

出　　处：《中国普外基础与临床杂志》2018年第9期1099-1102,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨影响T1期直肠癌淋巴结转移的危险因素。方法采用回顾性病例对照研究方法。收集2000年1月至2016年12月期间四川大学华西医院收治并接受根治性手术的247例原发性T1期直肠癌患者的临床病理资料,包括肿瘤大小(最大直径)、大体类型、分化程度、组织学类型、脉管浸润、神经浸润及癌结节。单因素分析采用χ~2检验,多因素分析采用logistic回归模型。结果 247例原发性T1期直肠癌患者中21(8.50%)例发生淋巴结转移,其中高分化T1期直肠癌患者未发生淋巴结转移。影响T1期直肠癌淋巴结转移的单因素分析结果显示,直肠癌的分化程度、组织学类型及癌结节与T1期直肠癌淋巴结转移有关(P<0.050);进一步的多因素分析结果显示,肿瘤低分化、黏液腺癌、印戒细胞癌及伴有癌结节是T1期直肠癌淋巴结转移的独立危险因素(OR=9.75、P=0.006,OR=5.98、P=0.042,OR=8.33、P=0.017,OR=10.87、P=0.026)。结论肿瘤低分化、黏液腺癌、印戒细胞癌及伴有癌结节是T1期直肠癌淋巴结转移的独立危险因素。Objective To explore risk factors of lymph node metastasis （LNM） in T1 rectal cancer. Methods The retrospective case-control study was conducted. The clinicopathologic data of 247 patients with T1 rectal cancer underwent radical resection were analyzed in the pathological database of the West China Hospital from January 2000 to December 2016, including the tumor size （maximum diameter）, gross type, differentiation degree, histological type, lymph vascular infiltration, perineural infiltration, and carcinoma nodule. The univariate analysis and multivariate analysis were done using the Chi-square test and logistic regression model, respectively. Results The rate of LNM in the patients with T1 rectal cancer was 8.50% （21/247）. No lymph metastasis was found in the well differentiated T1 rectal cancer. The results of the univariate analysis showed that the differentiation degree, histological type, and carcinoma nodule were related to the LNM in the T1 rectal cancer （P〈0.050）. The results of the multivariate analysis revealed that the poor differentiation, mucinous adenocarcinoma, signet-ring cell carcinoma, and carcinoma nodule were the independent risk factors of the LNM in the T1 rectal cancer （OR=9.75, P=0.006; OR=5.98, P=0.042; OR=8.33, P=0.017; OR=10.87, P=0.026）. Conclusion In this large population dataset, poor differentiation, mucinous adenocarcinoma, signet-ring cell carcinoma, and carcinoma nodule are risk factors of LNM in T 1 rectal cancer.

关 键 词：T1期直肠癌 淋巴结转移 危险因素 局部切除术 

分 类 号：R735.37[医药卫生—肿瘤]