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目的:探讨进展期结肠癌根治术后肿瘤复发转移的危险因素,为防治术后复发提供指导建议。方法:选取实施结肠癌根治手术的208例进展期结肠癌患者作为研究对象,根据3年随访患者是否发生转移、复发及死亡分为复发组(97例)和未复发组(111例),对两组患者各项临床资料进行单因素分析和多因素分析,筛选出复发转移的危险因素。结果:复发组与未复发组患者间肿瘤分化程度、淋巴结转移率、血管侵犯、脉管癌栓、术后辅助性化疗差异具有统计学意义(P<0.05);以是否发生复发转移作为因变量,分化程度、淋巴结转移、血管侵犯、脉管癌栓、术后辅助性化疗作为自变量,选择进入建立模型,结果显示,低分化、发生淋巴结转移、发生血管侵犯、发生脉管癌栓是进展期结肠癌根治术后复发转移的危险因素(OR=3.297、OR=3.098、OR=4.183、OR=4.875,P<0.05),术后辅助化疗是进展期结肠癌根治术后复发转移的保护因素(OR=0.242,P<0.05)。结论:进展期结肠癌根治术后复发转移的危险因素为低分化、发生淋巴结转移、发生血管侵犯、发生脉管癌栓,术后采取化疗措施具有减少复发、转移的效果。
Objective: To investigate the risk factors of recurrence and metastasis of advanced colon cancer after radical operation and provide guidance for prevention and treatment of postoperative recurrence. Methods: A total of 208 patients with advanced colon cancer undergoing radical resection of colon cancer were enrolled in this study. Patients were divided into recurrence group (n = 97) and non-recurrence group (n = 111) according to whether metastasis, The two groups of patients with clinical data univariate and multivariate analysis, screening out the risk factors for recurrence and metastasis. Results: There was significant difference in the degree of tumor differentiation, lymph node metastasis, vascular invasion, vascular cancer embolus and postoperative adjuvant chemotherapy between the recurrent and non-recurrent patients (P <0.05). The incidence of recurrence and metastasis was considered as the dependent variable , Degree of differentiation, lymph node metastasis, vascular invasion, vascular cancer thrombus and postoperative adjuvant chemotherapy as the independent variables, we chose to enter into the established model. The results showed that the progress of the poorly differentiated lymph node metastasis and vascular invasion occurred in the occurrence of vascular thrombosis (OR = 3.297, OR = 3.098, OR = 4.183, OR = 4.875, P <0.05). The postoperative adjuvant chemotherapy is the protective factor of the recurrence and metastasis of advanced colon cancer after radical operation (OR = 0.242, P <0.05). Conclusion: The risk factors for recurrence and metastasis of advanced colon cancer after radical resection are poorly differentiated, lymph node metastasis, vascular invasion and vascular embolism. Postoperative chemotherapy can reduce the recurrence and metastasis.