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目的探讨影响结直肠印戒细胞癌患者远期生存的相关因素。方法对我院1990年1月至2010年12月11年期间37例接受外科手术治疗的结直肠印戒细胞癌患者的临床资料进行回顾性分析。结果 37例结直肠印戒细胞癌患者中行根治性手术者21例,行肿瘤姑息性手术(切除+造口)者16例。患者术后1、2、3、5年累积生存率分别为70.3%、51.4%、27.0%和10.8%,生存时间为26个月。单因素分析结果显示,结直肠印戒细胞癌患者的TNM分期、T分期、是否合并肠梗阻、手术方式及术后是否接受化疗与术后生存时间有关(P<0.05),而患者的性别、年龄、N分期和肿瘤部位与此无关(P>0.05)。进一步行多因素Cox回归分析结果显示,患者的肿瘤TNM分期、T分期和是否合并肠梗阻是影响结直肠印戒细胞癌患者生存时间的独立预后指标(P<0.05)。结论结直肠印戒细胞癌远期生存率较低,肿瘤分期比较晚、肿瘤局部浸润生长使患者容易出现腹腔种植转移和肠道梗阻是影响患者远期生存的重要因素,化疗在一定程度上能够延长患者的生存时间。
Objective To explore the factors that affect the long-term survival of patients with signet-ring cell carcinoma of colorectal cancer. Methods The clinical data of 37 patients with colorectal signet-ring cell carcinoma undergoing surgery from January 1990 to December 2010 in our hospital were analyzed retrospectively. Results Of the 37 patients with colorectal signet-ring cell carcinoma, 21 underwent radical surgery and 16 patients underwent palliative surgery (resection and ostomy). The cumulative survival rates at 1, 2, 3, and 5 years after surgery were 70.3%, 51.4%, 27.0% and 10.8%, respectively, and the survival time was 26 months. Univariate analysis showed that TNM staging, T staging, whether intestinal obstruction, operation mode and postoperative chemotherapy were related to survival time (P <0.05), and gender, Age, N stage and tumor location have nothing to do with this (P> 0.05). Further analysis of multivariate Cox regression showed that TNM stage, T stage and whether intestinal obstruction were independent prognostic factors of survival time of patients with signet ring cell carcinoma of the colon (P <0.05). Conclusion The long-term survival rate of colorectal signet-ring cell carcinoma is low and the tumor staging is relatively late. The local invasion and growth of the tumor make the patients prone to metastasis and intestinal obstruction is an important factor affecting the long-term survival of patients. Chemotherapy can to some extent Extend the patient’s survival time.