结直肠癌根治术后患者预后影响因素分析  

Influencing factors of prognosis among patients undergoing radical resection for colorectal cancer

作　　者：张丽霞[1] 高垲 张婉婷 季邦菊[1] 张宇平[1] 李振军[1] 应晓江[1] 金明娟[2] 陈坤[2] 张丽华[1] ZHANG Lixia;GAO Kai;ZHANG Wanting;JI Bangju;ZHANG Yuping;LI Zhenjun;YING Xiaojiang;JIN Mingjuan;CHEN Kun;ZHANG Lihua(Department of Anorectal,Shaoxing People's Hospital(Shaoxing Hospital,Zhejiang University School of Medicine),Shaoxing 312000,China)

机构地区：[1]绍兴市人民医院(浙江大学绍兴医院)肛肠科,312000 [2]浙江大学公共卫生学院流行病与卫生统计学系

出　　处：《浙江医学》2021年第17期1862-1864,1869,共4页Zhejiang Medical Journal

基　　金：国家自然科学基金资助项目(81673262)。

摘　　要：目的分析结直肠癌(CRC)根治术后患者预后影响因素。方法选取2015年1月至2019年12月在绍兴市人民医院就诊的657例CRC患者为研究对象,均接受CRC根治术。采用门诊复查和电话随访方式了解患者生存情况,采用log-rank检验比较不同临床特征患者生存率,采用Cox比例风险回归模型分析CRC根治术患者预后影响因素。结果中位随访时间为33.09个月,3年生存率分别为91.3%。年龄≥65岁、肿瘤位置在直肠、组织学类型为黏液腺癌/印戒细胞癌、肿瘤最大径>6 cm、分化程度为低分化、TNM分期为Ⅲ期、TNM分期为Ⅳ期的患者3年生存率均明显较低,其HR及95%CI分别为3.61(1.90~6.87)、2.07(1.06~4.03)、2.19(1.11~4.32)、2.13(1.00~4.52)、3.81(1.30~11.21)、2.57(1.28~5.15)和11.34(5.01~25.66)。结论年龄、肿瘤位置、组织学类型、肿瘤最大径、分化程度和TNM分期是CRC根治术患者预后的独立影响因素。Objective To investigate the influencing factors of prognosis among patients undergoing radical resection for colorectal cancer(CRC).Methods A total of 657 patients who received radical resection for CRC in Shaoxing People's Hospital from January 2015 to December 2019 were enrolled.The survival status of patients were determined by outpatient review and telephone follow-up.Log-rank test was used to compare the survival rate of patients with different clinical feature.Cox proportional hazard regression model was used to explore the influencing factors of prognosis.Results The median follow-up time was 33.09 months.The overall 3-year survival rate was 91.3%,respectively.Patients with age≥65 years,rectal cancer,mucinous adenocarcinoma/signet ring-cell carcinoma,maximum tumor diameter>6 cm,low differentiation degree,TNM stageⅢand TNM stage IV had a higher risk of death,and the corresponding HR(95%CI)was 3.61(1.90-6.87),2.07(1.06-4.03),2.19(1.11-4.32),2.13(1.00-4.52),3.81(1.30-11.21),2.57(1.28-5.15)and 11.34(5.01-25.66),respectively.Conclusion The age,tumor location,histological type,maximum tumor diameter,degree of differentiation,and TNM stage are the independent influencing factors of prognosis among CRC patients after radical resection.

关 键 词：结直肠癌 随访 预后 影响因素 

分 类 号：R735.34[医药卫生—肿瘤]