术前结直肠炎症对于结直肠癌局部进展的预测意义  

Predictive significance of preoperative colorectal inflammation for local progression of colorectal cancer

作　　者：李森茂[1] 陈永乐 廖艺[1] 何真[1] 柯嘉[1] 吴现瑞[1] 兰平[1] LI Senmao ; CHEN Yongle; LIAO Yi; HE Zhen; KE Jia; WU Xianrui; LAN Ping(Department of Gastrointestinal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen Uaiversity, Guangzhou 510630, China)

机构地区：[1]中山大学附属第六医院胃肠外科,广州510630

出　　处：《岭南现代临床外科》2018年第5期487-498,共12页Lingnan Modern Clinics in Surgery

基　　金：2017年国家重点研发计划-中国结直肠肿瘤筛查和干预技术研究(2017YFC30880)

摘　　要：目的研究术前结直肠非特异性炎症对结直肠肿瘤局部进展及预后的影响。方法本研究为回顾性队列研究,通过回顾中山大学附属第六医院2007年至2010年的结直肠癌患者。所有具备该中心术前肠镜资料或手术病理证实肠炎的患者纳入研究,分为炎症组(肠镜下肠炎及手术病理肠炎)及对照组;比较肿瘤分期、淋巴结转移、癌结节转移、其他手术病理资料及生存预后等指标;比较总体生存及肿瘤复发等随访情况,随访时间3年。结果回顾病例907例,纳入研究346例;其中炎症组患者共70例,包括镜下远处肠炎39例(20.2%)、镜下肿瘤原位肠炎16例(22.9%)手术病理肠炎15例(21.4%),对照组276例(78.8%)。炎症组进展期肿瘤发生率74.3%(P<0.001),淋巴结转移率62.3%(P<0.001),癌结节转移率40.2%(P=0.001)均高于对照组。经logistic回归分析,手术病理肠炎是进展期肿瘤(P=0.016)、淋巴结转移(P=0.017)及癌结节转移(P=0.017)的独立危险预后因素;镜下远处肠炎是进展期肿瘤(P=0.003)、淋巴结转移(P=0.017)的独立危险预后因素。结论手术前结直肠非特异性炎症与肿瘤的分期存在明确的相关性,此类病例可用于结直肠炎症与恶性肿瘤关系研究。Objective The aim is to identify the influence of non-specific colorectal inflammation on colorectal cancer and its clinical significance. Methods This study was a retrospective cohort study by reviewing colorectal cancer patients fl＇om the Sixth Affiliated Hospital of Sun Yat-sen University from 2007 to 2010. All patients with preoperative colonoscopy data or surgical pathology confirmed enteritis were included in the study ; divided into inflamnlation group （ enteric endoscopy and surgical pathology enteritis ） and control group ; comparison of tumor stage, lymph node metastasis, cancer nodule metastasis Other surgical pathological data and survival prognosis indicators ; follow-up of overall smwival and tumor recurI＇ence, followed up for 3 years. Results A retrospective study of 907 patients included 346 patients. Among them, 70 cases were in the inflammation group, including 39 cases of distant enteritis （20.2%） , and 16 cases of tumor-in situ enteritis. 22.9%）, 15 cases （21.4%） with surgical pathology and 276 （78.8%） in the control group. In the inflammatory group, the tumor incidence rate was 74.3% （P〈0.001） , lymph node metastasis rate was 62.3% （P〈0.001） , and cancer nodule metastasis rate was 40.2% （P=0.001）. Logistic regression analysis showed that surgical pathology enteritis was an independent risk prognostic factor for advanced tumors （P=0.016）, lymph node metastasis （P=0.017）, and cancer nodule metastasis （P=0.017）. Prostate distant enteritis was independent risk prognostic factors for advanced tumor （P= 0.003） and lymph node metastasis （P=0.017）. Conclusion There is a clear correlation between non-specific inflammation of the colorectal before surgery and the staging of the tumor. Such cases can be used to study the relationship between coloreetal inflammation and malignant tumors.

关 键 词：结直肠非特异性炎症 结直肠癌 肿瘤分期 

分 类 号：R657.1[医药卫生—外科学]