论文部分内容阅读
目的:分析结直肠癌肿瘤最大径最佳截点及其与患者临床病理特点及预后的关系。方法:选择2006年1月—2012年7月行结直肠癌根治术与术后行规范化辅助治疗的结直肠癌患者119例的临床资料。采用Kaplan-Meier生存分析方法,筛选结直肠癌肿瘤最大径的最佳截点值;分析肿瘤最大径与结直肠癌患者临床病理因素的关系,并分析结直肠癌患者预后影响因素。结果:以最大径4 cm为截点,两侧患者生存率差异最明显(65.5%vs.51.1%,χ2=9.922,P=0.002),故确定结直肠癌肿瘤最大径最佳截点值为4 cm。肿瘤最大径<4 cm患者与≥4 cm患者在肿瘤T分期、淋巴结检出总数、血清CEA方面差异有统计学意义(均P<0.05)。单因素分析显示,肿瘤最大径、T分期、M分期、血清CEA水平、是否输血与结直肠癌预后有关(均P<0.05);多因素分析表明,肿瘤最大径、T分期、是否输血是结直肠癌预后的独立影响因素(均P<0.05);按肿瘤最大径分层分析,T分期是≥4 cm患者预后的独立影响因素(HR=2.244,95%CI=1.079~4.665,P=0.030),但以上因素对肿瘤最大径<4 cm患者预后影响不明显(均P>0.05)。结论:肿瘤最大径可作为影响结直肠癌预后的独立影响因素,其最佳截点值为4 cm,参照该截点值,有助于对患者临床特点及预后作出判断。
OBJECTIVE: To analyze the best cut-off point of maximum diameter of colorectal cancer and its relationship with the clinicopathological features and prognosis of patients. Methods: The clinical data of 119 patients with colorectal cancer who underwent radical resection of colorectal cancer and postoperative standardized adjuvant therapy from January 2006 to July 2012 were selected. The Kaplan-Meier survival analysis was used to screen the optimal cut-off point of the maximum diameter of colorectal cancer. The relationship between the maximum diameter of tumor and the clinicopathological factors of colorectal cancer was analyzed, and the prognostic factors of colorectal cancer were analyzed. Results: The maximal diameter of 4 cm as the cut-off point, the most obvious difference between the two sides survival rate (65.5% vs.51.1%, χ2 = 9.922, P = 0.002), so determine the colorectal cancer maximum diameter of the best cut- 4 cm. There were significant differences in T stage, total number of lymph nodes and serum CEA between patients with tumor diameter <4 cm and patients ≥ 4 cm (all P <0.05). Univariate analysis showed that the maximum tumor diameter, T stage, M stage, serum CEA level and blood transfusion were related to the prognosis of colorectal cancer (all P <0.05). Multivariate analysis showed that the maximum tumor diameter, T stage, The independent prognostic factors of rectal cancer were all independent prognostic factors (P <0.05). T-staging was the independent prognostic factor in patients with ≥4 cm (HR = 2.244, 95% CI = 1.079-4.665, P = 0.030 ), But the above factors had no significant effect on the prognosis of patients with tumor diameter less than 4 cm (all P> 0.05). Conclusion: The maximum diameter of tumor can be used as an independent factor affecting the prognosis of colorectal cancer. The best cut-off point is 4 cm. With reference to the cut-off point, it is helpful to judge the clinical features and prognosis of patients.