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目的探讨结直肠癌(CRC)患者的临床特征及预后影响因素。方法选取2008年2月至2013年2月间收治的52例CRC患者,男性29例,女性23例,患者年龄为(54.5±13.2)岁;肿瘤原发部位为结肠30例,直肠22例;病理类型为腺癌23例,管状腺癌19例,黏液腺癌10例;分化程度为高分化19例,中分化23例,低分化10例;Dukes分期为A期9例,B期20例,C期19例,D期4例;远处转移情况为肝转移17例,肺转移15例;治疗方式为根治术35例,姑息治疗17例。分析患者的临床特点,并探讨影响患者预后的相关因素。结果单因素分析显示,患者发病年龄、肿瘤直径、分化程度、远处转移、Dukes分期及治疗方式与CRC患者的预后有关(均P<0.05)。Cox回归分析结果显示,发病年龄(<40岁)、肿瘤直径(4~8 cm)、分化程度、Dukes分期及治疗方式(是否接受手术根治)是影响CRC患者预后的独立因素(均P<0.05)。结论影响CRC预后的因素有发病年龄、肿瘤直径、分化程度、Dukes分期及治疗方式等,临床应注重早期筛查、早期确诊、早期治疗,以改善患者的预后。
Objective To investigate the clinical characteristics and prognostic factors in patients with colorectal cancer (CRC). Methods Totally 52 CRC patients were treated in our hospital from February 2008 to February 2013, including 29 males and 23 females. The age of the patients was (54.5 ± 13.2) years old. The primary tumor was composed of 30 cases of colon and 22 cases of rectum. The pathological types were adenocarcinoma in 23 cases, tubular adenocarcinoma in 19 cases and mucinous adenocarcinoma in 10 cases. The differentiation was highly differentiated in 19 cases, moderately differentiated in 23 cases and poorly differentiated in 10 cases. The Dukes stage was stage A in 9 cases and stage B in 20 cases , 19 cases of stage C, 4 cases of stage D; 17 cases of distant metastasis were liver metastasis and 15 cases of lung metastasis; 35 cases were treated by radical operation and 17 cases were treated by palliative treatment. Analysis of the clinical features of patients and explore the impact of prognosis of patients related factors. Results Univariate analysis showed that the age of patients, tumor diameter, differentiation, distant metastasis, Dukes staging and treatment were related to the prognosis of CRC patients (all P <0.05). Cox regression analysis showed that the age of onset (<40 years), the diameter of tumor (4 ~ 8 cm), the degree of differentiation, the Dukes stage and the treatment mode (whether or not radical surgery) were independent prognostic factors of CRC patients (all P <0.05 ). Conclusions The factors affecting the prognosis of CRC are age of onset, tumor diameter, differentiation degree, Dukes staging and treatment modalities. Early screening, early diagnosis and early treatment should be emphasized in clinical practice to improve the prognosis of patients.