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目的探讨Dukes A期及B期大肠癌术后局部复发或者远处转移的危险因素。方法对2000年2月-2003年2月间首次实施根治性手术的Dukes A期及B期者65例,随访至2008年2月。局部复发的诊断应用肠镜及病理检查,远处转移的诊断应用B超或CT检查。结果全组患者术后5年共3例局部复发,复发率4.8%(3/65)。6例发生肿瘤远处转移,转移率9.6%(9/65)。肿瘤部位(R=-0.257,P=0.039)及局部浸润深度(R=-0.339,P=0.006)与复发相关。肿瘤局部浸润深度(R=-0.255,P=0.04)、神经受累(R=0.251,P=0.044)、术后放疗(R=0.307,P=0.013)、术后化疗(R=-0.431,P=0.007)与肿瘤远处转移相关。结论较早期的大肠癌患者根治术后仍有复发或者转移的可能性,术后化疗可减小Duke B期大肠癌患者术后转移的发生。
Objective To investigate the risk factors of local recurrence or distant metastasis of Dukes A and B colorectal cancer after operation. Methods Sixty-five patients with Dukes A and B who underwent radical operation for the first time from February 2000 to February 2003 were followed up to February 2008. Local recurrence of the diagnosis of colonoscopy and pathological examination, the diagnosis of distant metastasis by B-ultrasound or CT examination. Results All patients had local recurrence in 3 cases 5 years after operation, the recurrence rate was 4.8% (3/65). 6 cases of distant metastasis of tumor, the transfer rate of 9.6% (9/65). The location of tumor (R = -0.257, P = 0.039) and the depth of local invasion (R = -0.339, P = 0.006) were associated with recurrence. (R = -0.255, P = 0.04), nerve involvement (R = 0.251, P = 0.044), postoperative radiotherapy (R = 0.307, P = 0.013), postoperative chemotherapy (R = -0.431, P = 0.007) is associated with distant metastasis of the tumor. Conclusion The patients with early stage colorectal cancer still have the possibility of recurrence or metastasis after radical operation. Postoperative chemotherapy can reduce the postoperative metastasis of Duke B stage colorectal cancer patients.