术前不同贫血类型与结直肠癌患者病理特征及预后的相关性  

Correlation of Preoperative Anemia Types with Pathological Features and Prognosis in Patients with Colorectal Cancer

作　　者：郭厚基[1] 杨梅[1] 覃忠卫[1] 黄展易[1] GUO Houji;YANG Mei;QIN Zhongwei;HUANG Zhanyi(Dept.of Anorectal Surgery,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise Guangxi 533000,China)

机构地区：[1]右江民族医学院附属医院肛肠外科,广西百色533000

出　　处：《昆明医科大学学报》2023年第12期165-170,共6页Journal of Kunming Medical University

基　　金：百色市科学研究与技术开发计划基金资助项目(百科20213214)。

摘　　要：目的分析术前不同贫血类型(小细胞性贫血、正常细胞性贫血)与结直肠癌患者病理特征及预后的相关性。方法回顾性分析2018年3月至2021年2月于右江民族医学院附属医院接受根治手术的130例结直肠癌患者临床资料,根据红细胞形态学将患者分为A组(无贫血,70例)、B组(小细胞性贫血,18例)、C组(正常细胞性贫血,42例)。对比3组病理特征、术后2 a生存率,经Phi系数检验分析术前贫血类型与结直肠癌病理特征相关性,绘制Kaplan-Meier生存曲线对比3组生存率。结果3组性别、肿瘤部位、肿瘤直径、TNM分期分布相比,差异有统计学意义(P<0.05);经Phi系数检验发现,术前贫血类型与性别、肿瘤部位、肿瘤直径、TNM分期相关(r=0.238、0.255、0.266、0.331,P=0.025、0.015、0.010、0.001);经多因素Logistic回归分析发现,肿瘤直径≥5 cm、TNM分期为Ⅲ~Ⅳ期、远处转移、淋巴结转移、术前小细胞性贫血、术前正常细胞性贫血是影响结直肠癌根治术后预后的危险因素(OR>1,P<0.05);术后2a总生存率A组>C组>B组(P<0.05);经Log-rank检验,3组术后生存率相比,差异有统计学意义(P<0.05)。结论术前贫血类型与结直肠癌患者肿瘤部位、肿瘤直径、TNM分期等病理特征及术后生存时间相关,其中术前小细胞性贫血患者的生存率最低。Objective To analyze the correlation between different types of anemia(small cell anemia and normal cell anemia)before operation and pathological features and prognosis of colorectal cancer patients.Methods The clinical data of 130 patients with colorectal cancer who underwent radical surgery in our hospital from March 2018 to February 2021 were retrospectively analyzed.According to the morphology of red blood cells,the patients were divided into group A(70 cases without anemia),group B(18 cases with small cell anemia)and group C(42 cases with normal cell anemia).Pathological features and postoperative 2 a survival rate of the 3 groups were compared.The correlation between preoperative anemia types and pathological features of colorectal cancer was analyzed by Phi coefficient test,and Kaplan-Meier survival curve was drawn to compare the survival rate of the 3 groups.Results There were significant differences in gender,tumor site,tumor diameter and TNM stage distribution among the three groups(P<0.05).The Phi coefficient test showed that preoperative anemia type was correlated with gender,tumor site,tumor diameter,and TNM stage(r=0.238,0.255,0.266,0.331,P=0.025,0.015,0.010,0.001).Multivariate Logistic regression analysis showed that tumor diameter≥5 cm,TNM stageⅢ-Ⅳ,distant metastasis,lymph node metastasis,preoperative small cell anemia,preoperative normal cell anemia were the risk factors for the prognosis of colorectal cancer after radical surgery(OR>1,P<0.05).The overall survival rate of 2a in group A was higher than that in group C>that in group B(P<0.05).Log-rank test showed that the postoperative survival rate of the three groups was significantly different(P<0.05).Conclusion Preoperative anemia types were correlated with tumor site,tumor diameter,TNM stage and postoperative survival time of colorectal cancer patients,among which preoperative small-cell anemia patients had the lowest survival rate.

关 键 词：结直肠癌根治术 贫血类型 病理特征 预后 

分 类 号：R735.55[医药卫生—肿瘤]