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本文总结了协作组3122例结直肠癌手术根治病例,都有随访资料。全部病例5年生存率为50.2%。肿瘤浸润肠壁不同深度时,各组5年生存率差异有极显著意义(P<0.001)。当肿瘤侵犯肠壁不同深度时:各年龄组、解剖部位、侵犯肠管周径、肿瘤大小、大体类型、组织学类型之间比较、5年生存率差异具有显著意义(P<0.02～0.001)。淋巴结转移的有无,转移淋巴结个数,转移淋巴结分群之间5年生存率比较差异亦有显著意义(P<0.05～0.001)。本文还比较了国内外结直肠癌各种临床病理分期改良法,结合本组材料5年生存率差异的显著性,建议将肿瘤浸润粘膜内外统一为 A_1期,浅肌层和深肌层分别为 A_2 和 A_3 期,浆膜内外分别为 B_1 和 B_2 期。有关影响结直肠癌预后的各种因素国内外已有不少报导。从各种因素分析看,肿瘤部位,肿瘤体积,大体类型,组织学类型,肠壁浸润,淋巴结转移,淋巴结反应,肿瘤免疫细胞反应等因素对预后均有影响。其中以肠壁浸润深度和免疫细胞反应两项指标有最显著的意义。现就本协作组3122例预后结果进行对比分析。结合反映肿瘤浸润范围的临床病理分期进行探讨,并提出修正意见。
This article summarized the follow-up data of 3122 cases of colorectal cancer surgery in the collaborative group. The 5-year survival rate was 50.2% in all cases. When tumors infiltrated the intestine wall at different depths, the difference in 5-year survival rate between the groups was extremely significant (P<0.001). When the tumors invaded different depths of the intestine wall: there was a significant difference between the age groups, anatomical sites, invading the perimeter of the intestine, tumor size, gross type, histological type, and 5-year survival rate (P<0.02-0.001). The presence or absence of lymph node metastasis, the number of metastatic lymph nodes, and the 5-year survival rate among metastatic lymph node clusters were also significantly different (P < 0.05-0.001). This article also compared the clinical and pathological staging of colorectal cancer at home and abroad, combined with the significant difference in the 5-year survival rate of this group of materials, it is recommended that the tumor infiltrates the mucosa in and out of the A1 phase, the superficial and deep muscular layers are In the A_2 and A_3 phases, the B_1 and B_2 phases are inside and outside the serosa. There have been many reports on various factors affecting the prognosis of colorectal cancer at home and abroad. From the analysis of various factors, the tumor site, tumor volume, gross type, histological type, intestinal wall infiltration, lymph node metastasis, lymph node response, tumor immune cell response and other factors have an impact on prognosis. Among them, the depth of intestinal wall infiltration and the immune cell response are the two most significant indicators. The results of 3122 cases of prognosis in this collaborative group are compared and analyzed. The clinicopathological stage reflecting the extent of tumor invasion was explored and amendments were proposed.