论文部分内容阅读
目的研究青年、中年和老年组大肠癌预后的影响因素,指导临床治疗。方法对842例行根治术后的大肠癌患者,按发病年龄分为青年组(≤40岁)、中年组(41～64岁)和老年组(≥65岁)。用SPSS软件分别对3组患者的35个临床病理因素进行单因素生存分析和多因素Cox比例风险模型回归分析。结果842例大肠癌的5,10,15年生存率分别为66.3%、54.2%和48.5%,青年组大肠癌的5,10年生存率分别为53.0%和42.7%,低于其他年龄组患者。多因素分析显示,Dukes分期和家族肿瘤史为青年和中年组大肠癌患者的共同影响因素;慢性便秘是中年组大肠癌预后的独立影响因素;肠梗阻、手术时间、转移淋巴结数为老年组大肠癌的预后因素。病程(从出现症状到手术时间)不是影响青年组大肠癌的主要原因。青年组DukesA期患者的5,10年生存率分别为82.6%和64.5%,B期分别为73.3%和67.4%,C期分别为37.3%和27.0%,D期分别为33.3%和22.2%。青年组A期和B期患者生存率与中老年组相近,但C期和D期的生存率低于中老年组。有家族肿瘤史的青年组患者预后好,其5,10年生存率分别为73.1%和64.5%,显著高于无家族肿瘤史患者的48.1%和37.3%。结论不同年龄组大肠癌预后影响因素有差异,青年组大肠癌的生存率明显低于其他年龄组。在青年组,大肠癌Dukes分期晚和无家族肿瘤史的患者预后差,病程不是影响预后的因素,青年组大肠癌患者预后差与就诊时间晚、延误诊断无关。
Objective To study the influencing factors of prognosis of colorectal cancer in young, middle-aged and elderly patients and to guide the clinical treatment. Methods 842 patients with colorectal cancer after radical operation were divided into young group (≤40 years), middle aged group (41 ~ 64 years) and elderly group (≥65 years old) according to their age of onset. SPSS software was used to analyze the 35 clinical and pathological factors of three groups of patients respectively by one-way survival analysis and multivariate Cox proportional hazards model regression analysis. Results The 5-year, 10-year and 15-year survival rates of 842 cases of colorectal cancer were 66.3%, 54.2% and 48.5% respectively. The 5-year and 10-year survival rates of colorectal cancer in young group were 53.0% and 42.7%, lower than those in other age groups . Multivariate analysis showed that Dukes staging and familial tumor history were the common influencing factors of colorectal cancer in young and middle-aged patients. Chronic constipation was an independent prognostic factor in middle-aged patients. Intestinal obstruction, operation time, Group of colorectal cancer prognostic factors. The course of the disease (from symptoms to surgery) was not the major cause of colorectal cancer in the youth group. The 5-year and 10-year survival rates were 82.6% and 64.5% in the Dukes A stage of young patients, 73.3% and 67.4% in the B stage, 37.3% and 27.0% in the C stage, and 33.3% and 22.2% in the D stage, respectively. The survival rates of patients in stage A and B in youth group were similar to those in middle-aged and elderly patients, but the survival rates in stage C and D were lower than those in middle-aged and elderly patients. The younger patients with a family history of cancer had a better prognosis, with a 5-year and 10-year survival rate of 73.1% and 64.5%, respectively, significantly higher than those of patients without family history of cancer (48.1% vs 37.3%). Conclusion The prognostic factors of colorectal cancer in different age groups are different. The survival rate of colorectal cancer in young group is obviously lower than that in other age groups. In the youth group, the prognosis of patients with late stage of Dukes staging of colorectal cancer and no family history of tumor was poor. The course of disease was not the factor of prognosis. The poor prognosis of colorectal cancer patients in youth group was not related to late diagnosis and delayed diagnosis.