超低位直肠癌保肛手术术后患者生存分析及预后影响因素分析  

Survival and prognostic factors of ultra-low rectal cancer patients after anus-preserving surgery

作　　者：赵蕾 徐天生 龚江 蔡颖畅 Lei Zhao;Tian-Sheng Xu;Jiang Gong;Ying-Chang Cai(Quzhou Hospital Affiliated to Wenzhou Medical University(Quzhou People’s Hospital),Quzhou 324000,Zhejiang Province,China)

机构地区：[1]温州医科大学附属衢州医院(衢州市人民医院),浙江省衢州市324000

出　　处：《世界华人消化杂志》2022年第17期762-768,共7页World Chinese Journal of Digestology

摘　　要：背景结直肠癌是一种恶性程度较高的肿瘤,采用超低位直肠癌保肛手术肿瘤科有效延长患者生存期,但患者术后生存状况受多方面因素影响,积极探究相关影响因素对临床加强术后干预、改善患者生存质量具有重要指导价值.目的探究超低位直肠癌保肛手术术后患者生存状况,并分析其预后影响因素.方法选取2016-03/2018-03我院152例低位直肠癌患者,均行超低位直肠癌保肛手术治疗,统计术后1年、2年、3年总存活率、无病存活率,比较不同预后患者围术期临床资料,分析预后影响因素.结果超低位直肠癌保肛手术术后患者1年、2年、3年总存活率分别为100%、89.8%、70.75%,无病存活率分别为91.16%、76.19%、60.54%;术后3年存活患者围术期年龄、肿瘤直径、血清糖类抗原125(carbohydrate antigen125,CA125)、癌胚抗原(carcinoembryonic antigen,CEA)、缺氧诱导因子1α(hypoxiainducible factorα,HIF-1α)水平、TNM分期、术后尿管留置时间均小于死亡患者,淋巴结转移、脉管侵犯、神经侵犯发生率均低于死亡患者,距肛缘距离、血清微小RNA-192(microR NA-192,miR-192)水平、分化程度、营养预后指数和白球比(prognostic nutritional index and albumintoglobulinratio,PNAG)评分均高于死亡患者,差异有统计学意义(P<0.05);距肛缘距离、血清CA125、CEA、HIF-1α、血清miR-192水平、PNAG评分、术后尿管留置时间与超低位直肠癌保肛手术术后患者预后显著相关(P<0.05).结论超低位直肠癌保肛手术术后患者3年总存活率超过70%,肿瘤距肛缘距离、血清CA125、CEA、HIF-1α、miR-192水平、PNAG评分、术后尿管留置时间均为预后影响因素.BACKGROUND Colorectal cancer is a highly malignant tumor.Anuspreserving surgery can effectively prolong the survival of patients with ultra-low rectal cancer.However,the postoperative survival of patients is affected by many factors.Identification of the relevant prognostic factors is of important guiding value in enhancing postoperative intervention and improving the quality of life of patients.AIM To explore the survival of patients with ultra-low rectal cancer after anus-preserving surgery,and to analyze the prognostic factors.METHODS A total of 152 patients with low rectal cancer were selected from March 2016 to March 2018 at our hospital,all of whom received anus-preserving surgery for ultra-low rectal cancer.The overall survival rate and disease-free survival rate at 1,2,and 3 years after surgery were analyzed.The perioperative clinical data of patients with different prognostic conditions were compared,and the prognostic factors were analyzed.RESULTS The 1-,2-,and 3-year overall survival rates were 100%,89.8% and 70.75%,respectively,and the 1-,2-,and 3-year disease-free survival rates were 91.16%,76.19%,and 60.54%,respectively.Age at surgery,tumor diameter,serum carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA),hypoxia-inducing-factor 1α(HIF-1α) levels,TNM stage,and postoperative catheter indwelling time of patients who survived 3 years after surgery were all lower than those of patients who died,and the incidence of lymph node metastasis,vascular invasion,and nerve invasion was lower than that of patients who died.The distance from anal margin,serum miR-192 level,differentiation degree,and PNAG score were all significantly higher than those of dead patients(P < 0.05).The distance to the anal margin,serum CA125,CEA,HIF-1α,and miR-192 levels,PNAG score,and postoperative catheter indwelling time were significantly correlated with the prognosis of patients with ultra-low rectal cancer after anus-preserving surgery(P < 0.05).CONCLUSION The 3-year overall survival rate of patients with ultra-low

关 键 词：直肠癌 超低位直肠癌保肛手术 生存状况 影响因素 

分 类 号：R735.37[医药卫生—肿瘤]