直肠癌与肛门距离影响因素的分位数回归分析  

Quantile regression analysis of factors associating with the distance from the anal verge to rectal cancer

作　　者：闫强[1] 汪圣毅[1] 李永翔[1] Yan Qiang;Wang Shengyi;Li Yongxiang(Dept of General Surgery,Dept of Gastrointestinal Surgery,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院普外科胃肠外科,合肥230022

出　　处：《安徽医科大学学报》2023年第3期476-480,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:81672389)。

摘　　要：目的探讨直肠癌与肛门距离的影响因素。方法收集102例直肠癌患者的临床和病理资料,直肠癌与肛门的距离(DAVtRC)≤7 cm为低位直肠癌(LRC)组、DAVtRC>7cm为中高位直肠癌(M/HRC)组,比较组间临床病理因素的差异。分位数回归分析DAVtRC与临床病理因素的关系。结果LRC组DAVtRC的中位数[5.00 cm(IQR:4.00,6.00 cm)]低于M/HRC组[10.00 cm(IQR:10.00,11.00cm),P<0.01],但单核细胞平均数较高[(0.41±0.16)vs(0.34±0.11),P<0.05]。95%分位数时,模型纳入连续和分类自变量,DAVtRC与年龄(β=-0.204,P<0.01)、TNM分期(Ⅲ+Ⅳ)期与Ⅰ期(β=-6.623,P<0.01)、血小板(PLT,β=-0.024,P<0.01)、血管侵犯(β=-1.544,P<0.01)负相关,与BMI(β=0.278,P<0.01)、肿瘤直径(β=0.548,P<0.01)、男性(β=1.421,P<0.01)、肿瘤低中分化(β=4.727,P<0.01)、T分期(T2与T1比较:β=4.422,P<0.01)、N分期(N1与N0比较:β=6.670,P<0.01)、神经侵犯(β=1.825,P<0.01)、癌胚抗原(CEA,β=0.068,P<0.01)、淋巴细胞(L,β=3.068,P<0.01)、血小板淋巴细胞比(PLR,β=0.045,P<0.01)、淋巴细胞单核细胞比(LMR,β=1.088,P<0.01)正相关。回归曲线显示:年龄、体质量指数(BMI)、肿瘤直径、PLT、PLR、LMR在不同分位数的系数不同。结论DAVtRC与多种临床病理因素有关,不同分位数的系数大小和方向不同。Objective To explore the factors associated with the distance from the anal verge to rectal cancer(DAVtRC).Methods 102 patients with rectal cancer provided the clinicopathological data.Two groups of patients were created:low rectal cancer group(LRC)for those with DAVtRCs less than 7cm and mid/high rectal cancer group(M/HRC)for those with DAVtRCs greater than 7 cm.The two groups′clinical and pathological differences were compared.Quantile regression was used to analyze the associations between DAVtRC and the clinicopathological factors.Results LRC had a lower median DAVtRC(5.00 cm[IQR:4.00,6.00 cm])than that in M/HRC[10.00 cm(IQR:10.00,11.00 cm)](P<0.01),but had higher mean monocytes[(0.41±0.16)vs(0.34±0.11),P<0.05].In the model with continuous and categorical variables at 95% quantile,DAVtRC was negatively associated with age(β=-0.204,P<0.01),TNM stage(Ⅲ+ⅣvsⅠ:β=-6.623,P<0.01),platelet(PLT,β=-0.024,P<0.01),vessel invasion(β=-1.544,P<0.01),but positively associated with BMI(β=0.278,P<0.01),tumor diameters(β=0.548,P<0.01),male(β=1.421,P<0.01),low and middle differentiations(β=4.727,P<0.01),T stage(T2 vs T1:β=4.422,P<0.01),N stage(N1 vs N0:β=6.670,P<0.01),nerve invasion(β=1.825,P<0.01),carcinoembryonic antigen(CEA,β=0.068,P<0.01),lymphocyte(L,β=3.068,P<0.01),platelet lymphocyte ratio(PLR,β=0.045,P<0.01),lymphocyte monocyte ratio(LMR,β=1.088,P<0.01).Quantile regression curves showed that the coefficients of age,body mass index(BMI),tumor diameter,PLT,PLR and LMR were different in different quantiles of DAVtRC.Conclusion DAVtRC is significantly associated with multiple clinicopathological factors in rectal cancer,but in different quantiles,the coefficients are different.

关 键 词：直肠肿瘤 直肠癌与肛门的距离 低位直肠癌 分位数回归 临床病理因素 

分 类 号：R735.37[医药卫生—肿瘤] R604[医药卫生—临床医学]