专题研究(Monographic Study)

脉管癌栓浸润对II期结肠癌患者预后影响分析

Published at: 2016年第25卷第10期

王秀秀 1 , 隋柏强 2 , 单连峰 1
1 中国医科大学公共基础学院 数学教研室,辽宁 沈阳 110122
2 中国医科大学附属第四医院 胃肠外科,辽宁 沈阳110032
通讯作者 连峰 单 Email: lfshan@mail.cmu.edu.cn
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.10.009
基金:
国家自然科学基金资助项目 81372496

摘要

目的:探讨II期结肠癌患者脉管癌栓浸润的影响因素及其与预后的关系。方法:收集2007年1月—2010年8月中国医科大学附属第四医院行结肠癌根治术的152例II期结肠癌患者临床病理资料,分析患者的脉管癌栓浸润与临床病理指标的关系,以及预后影响因素。结果:全组患者5年总生存率为73.7%,其中IIa、IIb、IIc期患者分别为79.6%、73.3%、65.8%。统计学分析显示,脉管癌栓浸润与结肠癌肿瘤部位、分化程度和T分期明显有关(均P<0.05)。单因素分析显示,分化程度、切缘阳性、脉管癌栓浸润、淋巴结检出个数及T分期是结肠癌患者预后的影响因素(均P<0.05);多因素分析显示,T分期、切缘阳性和脉管癌栓浸润是影响生存的独立预后因素(均P<0.05)。脉管癌栓浸润阳性的患者5年生存率明显低于阴性的患者(52.7% vs. 85.6%,P<0.05),并且脉管癌栓浸润阳性患者中化疗患者5年生存率高于非化疗患者(60.7% vs. 44.4%,P<0.05)。结论:II期结肠癌患脉管癌栓浸润与肿瘤部位、分化程度、T分期有关,是影响II期结肠癌患者预后的独立危险因素,对脉管癌栓浸润阳性的II期结肠癌患者建议给予辅助化疗。


Prognostic role of lymphovascular tumor cell invasion in patients with stage II colon cancer

Abstract

Objective: To investigate the affecting factors for lymphovascular tumor cell invasion and its relation with prognosis in patients with stage II colon cancer. Methods: The clinicopathologic data of 152 patients with stage II colon cancer who underwent radical surgery in the Fourth Affiliated Hospital of China Medical University from January 2007 to August 2010 were collected. The relations of lymphovascular tumor cell invasion with clinicopathologic variables and the prognostic factors of the patients were analyzed. Results: The 5-year overall survival rate in the whole group of patients was 73.7%, which in patients with IIa, IIb and IIc disease was 79.6%, 73.3% and 65.8%, respectively. Statistical analysis showed that lymphovascular tumor cell invasion was significantly associated with tumor site, degree of differentiation and T stage of colon cancer (all P<0.05). Univariate analysis indicated that degree of differentiation, positive surgical margin, lymphovascular tumor cell invasion, number of detected lymph nodes and T stage were prognostic factors for patients with stage II colon cancer (all P<0.05); multivariate analysis identified that T stage, positive surgical margin and lymphovascular tumor cell invasion were independent prognostic factors for patients with in stage II colon cancer (all P<0.05). The 5-year survival rate in patients with positive lymphovascular invasion was significantly lower than in those without lymphovascular tumor cell invasion (52.7% vs. 85.6%, P<0.05). In addition, the 5-year survival rate in cases with positive lymphovascular tumor cell invasion undergoing chemotherapy was significantly higher than in those without chemotherapy (60.7% vs. 44.4%, P<0.05). Conclusion: In patients with stage II colon cancer, lymphovascular tumor cell invasion is related to tumor site, degree of differentiation and T stage, which is an independent risk factor for their prognosis. Adjuvant chemotherapy is recommended for stage II colon cancer patients with positive lymphovascular tumor cell invasion.


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引用

引用本文: 秀秀 王, 柏强 隋, 连峰 单. 脉管癌栓浸润对II期结肠癌患者预后影响分析[J]. 中国普通外科杂志, 2016, 25(10): 1420-1425.
Cite this article as: WANG Xiuxiu, SUI Baiqiang, SHAN Lianfeng . Prognostic role of lymphovascular tumor cell invasion in patients with stage II colon cancer [J]. Chin J Gen Surg, 2016, 25(10): 1420-1425.