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徐洪丽, 胡俊杰, 徐慧婷, 肖志华, 梁新军, 魏少忠. 不同原发部位结肠癌的临床病理及预后分析[J]. 肿瘤防治研究, 2018, 45(9): 672-675. DOI: 10.3971/j.issn.1000-8578.2018.18.0017
引用本文: 徐洪丽, 胡俊杰, 徐慧婷, 肖志华, 梁新军, 魏少忠. 不同原发部位结肠癌的临床病理及预后分析[J]. 肿瘤防治研究, 2018, 45(9): 672-675. DOI: 10.3971/j.issn.1000-8578.2018.18.0017
XU Hongli, HU Junjie, XU Huiting, XIAO Zhihua, LIANG Xinjun, WEI Shaozhong. Clinicopathologic Characteristics and Prognosis of Colon Cancer Patients with Different Primary Locations[J]. Cancer Research on Prevention and Treatment, 2018, 45(9): 672-675. DOI: 10.3971/j.issn.1000-8578.2018.18.0017
Citation: XU Hongli, HU Junjie, XU Huiting, XIAO Zhihua, LIANG Xinjun, WEI Shaozhong. Clinicopathologic Characteristics and Prognosis of Colon Cancer Patients with Different Primary Locations[J]. Cancer Research on Prevention and Treatment, 2018, 45(9): 672-675. DOI: 10.3971/j.issn.1000-8578.2018.18.0017

不同原发部位结肠癌的临床病理及预后分析

Clinicopathologic Characteristics and Prognosis of Colon Cancer Patients with Different Primary Locations

  • 摘要:
    目的 探讨不同原发部位的结肠癌患者临床病理及预后是否存在差异。
    方法 回顾性分析1 088例结肠癌患者的临床病理资料,应用Kaplan-Meier法进行生存分析,Log rank法比较生存率差异,肿瘤不同部位对预后影响的多因素分析采用Cox比例风险回归模型。
    结果 升结肠组患者平均年龄最大(61.1±12.3)岁,女性患者所占比例最高(47%)。升结肠组和横结肠组肿瘤直径(5.9±2.2 cm和5.8±2.4 cm)显著大于降结肠组及乙状结肠组(4.4±1.8 cm和4.6±1.7 cm)(P=0.000)。乙状结肠组Ⅰ期患者所占比例最高(9.9%),约为升结肠组的3倍(3.8%)(P=0.001)。升结肠组和横结肠组肿瘤中黏液分泌、低分化及未分化和脉管瘤栓比例均显著高于降结肠组及乙状结肠组,差异均有统计学意义。升结肠组、横结肠组、降结肠组和乙状结肠组患者5年总生存率分别为71.4%、75.4%、73.5%和79.7%,差异有统计学意义(P=0.000)。经多因素回归分析调整后,与升结肠组患者相比,乙状结肠组死亡风险显著降低(HR=0.68, 95%CI: 0.50~0.91)。按期别分层分析显示乙状结肠癌(HR=0.54, 95%CI: 0.32~0.90)在Ⅳ期结肠癌中预后最优。
    结论 不同原发部位的结肠癌患者临床病理及预后存在差异,Ⅳ期结肠癌中乙状结肠癌预后最佳。

     

    Abstract:
    Objective To examine clinicopathologic characteristics and survival differences of colon cancer patients by different primary locations.
    Methods We retrospectively analyzed the medical records of 1088 colon cancer patients. Kaplan-Meier curves were generated for colon subsite location, and survival curves were compared with the Log rank test. Cox proportional hazards regression models were used for multivariate survival analyses.
    Results Patients with ascending colon cancer were the oldest(mean age: 61.1±12.3 years) and predominantly were female (47%). Tumor diameters in ascending and transverse colon cancer groups (5.9±2.2cm and 5.8±2.4cm) were significantly larger than those in descending and sigmoid colon cancer groups(4.4±1.8cm and 4.6±1.7cm) (P=0.000). A larger proportion of sigmoid cancer group (9.9%) presented as stage Ⅰ compared with ascending colon cancer group (3.8%) (P=0.001). Ascending and transverse colon cancer groups were associated with a larger proportion of poorly-differentiated and undifferentiated adenocarcinoma, mucinous adenocarcinoma and vascular invasion than descending and sigmoid colon cancer groups, with significant difference. The five-year overall survival of ascending, transverse, descending and sigmoid colon cancer groups were 71.4%, 75.4%, 73.5% and 79.7% respectively (P=0.000). Multivariate adjusted overall survival analyses showed sigmoid colon cancer group had decreased risk of death compared with ascending colon cancer group (HR=0.68, 95%CI:0.50-0.91). In stage Ⅳ disease, sigmoid colon cancer group had the most favorable outcome (HR=0.54, 95%CI:0.32-0.90).
    Conclusion Colon cancer patients with different primary locations have different clinical data and survival, and those with stage Ⅳ sigmoid colon cancer have the best prognosis.

     

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