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目的比较结直肠癌手术切除标本中的脉管癌栓阳性患者与阴性患者预后差异。方法回顾性分析2005~2010年温州医科大学附属台州医院胃肠外科手术治疗的结直肠癌患者临床病理资料,用单因素分析探讨脉管癌栓和临床病理资料的关系。对可能影响患者生存的因素进行单因素和Cox多因素模型分析,分析可能影响结直肠癌预后的因素。Kaplan-Meie生存分析阳性脉管癌栓和结直肠癌患者生存预后关系。结果单因素方差分析发现:癌栓的发生率与肿瘤分化程度(P=0.01),淋巴结转移(P<0.001),TNM分期(P<0.001)关系密切,癌栓的发生同样和结直肠癌患者的生存率(P<0.001)有密切关系。Cox多危险因素回归分析发现:癌栓(P=0.001),淋巴结转移(P=0.025),TNM分期(P<0.001)可以作为结直肠癌患者的独立预后危险因素;从Kaplan-Meie生存分析中发现:脉管癌栓阴性的患者的生存率明显高于存在脉管癌栓阳性的患者(P<0.001)。结论脉管癌栓与淋巴结的转移关系密切,脉管癌栓阳性明显影响患者的生存预后,并且脉管癌栓可以作为结直肠癌患者的独立预后因素;因此我们认为针对此类高危患者,临床上应采取更积极更具有针对性的治疗来提高患者的生存质量和延长患者的生存时间。
Objective To compare the prognosis of patients with positive and negative vascular thrombosis in resected specimens of colorectal cancer. Methods The clinical and pathological data of patients with colorectal cancer treated by gastrointestinal surgery in Taizhou Hospital affiliated to Wenzhou Medical University from 2005 to 2010 were retrospectively analyzed. The relationship between vascular tumor thrombus and clinicopathological data was analyzed by univariate analysis. One-factor and Cox multivariate analysis of factors that may affect patient survival were performed to analyze the factors that may affect the prognosis of colorectal cancer. Survival and prognosis of Kaplan-Meier survival analysis in patients with positive vascular thrombosis and colorectal cancer. Results One-way analysis of variance showed that the incidence of tumor emboli was closely related to tumor differentiation (P = 0.01), lymph node metastasis (P <0.001) and TNM stage (P <0.001) The survival rate (P <0.001) is closely related. Cox regression analysis showed that tumor thrombus (P = 0.001), lymph node metastasis (P = 0.025) and TNM stage (P <0.001) were independent prognostic risk factors for colorectal cancer. According to the Kaplan-Meier survival analysis It was found that the survival rate of patients with negative vascular thrombosis was significantly higher than those with positive vascular thrombolysis (P <0.001). Conclusions The vascular thrombosis is closely related to the metastasis of lymph nodes. The positive of vascular thrombus can significantly affect the prognosis of patients, and the vascular thrombus can be used as an independent prognostic factor in patients with colorectal cancer. Therefore, we believe that for such high-risk patients, clinical Should take more aggressive and targeted treatment to improve the quality of life of patients and prolong the survival time of patients.