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Ⅲ期结肠癌患者预后因素分析和术前对预后评估的探索

潘宏达, 彭亦凡, 王 林, 顾 晋

潘宏达, 彭亦凡, 王 林, 顾 晋. Ⅲ期结肠癌患者预后因素分析和术前对预后评估的探索[J]. 肿瘤防治研究, 2013, 40(11): 1059-1063. DOI: 10.3971/j.issn.1000-8578.2013.11.011
引用本文: 潘宏达, 彭亦凡, 王 林, 顾 晋. Ⅲ期结肠癌患者预后因素分析和术前对预后评估的探索[J]. 肿瘤防治研究, 2013, 40(11): 1059-1063. DOI: 10.3971/j.issn.1000-8578.2013.11.011
PAN Hongda, PENG Yifan, WANG Lin, GU Jin. Prognostic Factors Analysis and Preoperative Prognostic Evaluation for StageⅢ Colorectal Cancer[J]. Cancer Research on Prevention and Treatment, 2013, 40(11): 1059-1063. DOI: 10.3971/j.issn.1000-8578.2013.11.011
Citation: PAN Hongda, PENG Yifan, WANG Lin, GU Jin. Prognostic Factors Analysis and Preoperative Prognostic Evaluation for StageⅢ Colorectal Cancer[J]. Cancer Research on Prevention and Treatment, 2013, 40(11): 1059-1063. DOI: 10.3971/j.issn.1000-8578.2013.11.011

Ⅲ期结肠癌患者预后因素分析和术前对预后评估的探索

详细信息
    作者简介:

    潘宏达(1987-),男,硕士在读,主要从事结直肠肿瘤的研究

  • 中图分类号: R735.3+5

Prognostic Factors Analysis and Preoperative Prognostic Evaluation for StageⅢ Colorectal Cancer

  • 摘要: 目的 探讨Ⅲ期结肠癌的预后因素及术前预后评估的可行性。方法 回顾性分析2004年1月至2008年6月间北京肿瘤医院外科手术治疗的Ⅲ期结肠癌患者临床病理资料,分析结肠癌的预后因素。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。结果 (1)全部Ⅲ期患者3年无病生存率为63.4%;(2)单因素分析发现术前血清CEA水平>5 ng/ml??肿瘤分化程度低、肿瘤直径≥5 cm??更高的N分期、TNM分期和脉管癌栓(P<0.05)是影响Ⅲ期患者预后的因素;(3)多因素回归分析术前血清CEA水平(P=0.000,RR=2.832,1.755~6.023),N分期(P=0.001,RR=1.456,1.522~4.984),肿瘤直径≥5 cm(P=0.015,RR=1.663,1.155~3.871)是Ⅲ期患者生存的独立预后危险因素。结论 根据术前血清CEA水平、肿瘤直径≥5 cm和更高N分期,可以对具有预后不良因素的Ⅲ期结肠癌患者进行更准确的风险分层,应针对Ⅲ期高危患者进行更积极的术前新辅助治疗以及更加密切的术后随访。

     

    Abstract: Objective To investigate the prognostic factors of stage Ⅲ (pT1-4N1-2M0) colon cancer, and discuss the feasibility of preoperative prognosis evaluation. Methods Clinicopathologic data of patients with stage Ⅲ colon cancer treated with curative surgery alone from January 2004 to June 2008 in Peking University Cancer Hospital was retrospectively reviewed,to analyze the prognostic factors of demographics, clinical, histopathologic, and laboratory data. Univariate and multivariate analysis were conducted to identify prognostic factors associated with 3-year disease-free survival (3yr DFS). Results There were 131 valid cases reviewed in this study, the 3yr DFS was 63.4%. Univariate analysis showed that preoperative CEA level >5 ng/ml, poor differentiation, tumor diameter ≥5 cm, higher N stage, TNM stage and lymphaticvessel invasion were the poor prognostic factors of patients with stage Ⅲ colon cancer (P<0.05). Multivariate analysis showed that preoperative CEA level (P=0.000, RR=2.832, 1.755-6.023), higher N stage(P=0.001, RR=1.456, 1.522-4.984), tumor diameter≥5 cm(P=0.015, RR=1.663, 1.155-3.871) were the independent prognostic factors for 3yr DFS. Conclusion According to the prognostic risk factors of preoperative CEA level,higher N stage and tumor diameter ≥5 cm, more accurate risk stratifi cation more intensive treatment and more closely surveillance could be conducted in patients with stage Ⅲ colon cancer.

     

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出版历程
  • 收稿日期:  2013-01-27
  • 修回日期:  2013-06-13
  • 刊出日期:  2013-11-24

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