结直肠癌独立预后因素:TNM分期、肿瘤芽、神经周围侵犯、瘤旁淋巴细胞浸润和尿糖

Study on independent factors on the prognosis of colorectal carcinoma: TNM stage,tumor budding,perineural invasion,peritumoral-lymphocytic infiltration and urine glucose

目的探讨临床因素与病理形态学因素对结直肠癌预后的影响。方法运用单因素及多因素Cox比例风险模型对226例结直肠癌的临床与病理形态学因素与预后的关系进行分析。结果单因素分析显示肿瘤浸润深度、脉管侵犯、神经周围侵犯、肿瘤芽、肿瘤间质淋巴细胞浸润、Crohn’s样反应、转移淋巴结数目、远处转移、TNM分期、尿糖与预后有关。多因素分析显示年龄大、TNM分期高、肿瘤芽级别高、存在神经周围侵犯、肿瘤间质淋巴细胞浸润少及尿糖阳性的相对危险度高。结论年龄、TNM分期、肿瘤芽、神经周围侵犯、肿瘤间质淋巴细胞浸润和尿糖是估计结直肠癌患者预后的独立指标。

Objective To study the influence of clinical and pathological-morphological parameters on the prognosis of colorectal carcinoma. Methods Univariate and multivariate Cox proportional hazard model were used to study the influence of clinical and pathological-morphological factors on the prognosis in 226 colorectal carcinoma cases. Results Using univariate analysis, data showed that the factors significantly related to disease prognosis would include:the depth of direct spread, vessel invasion, perineural invasion, tumor budding, peritumoral-lymphocytic infiltration, Crohn-like reaction, number of positive lymph nodes, distant metastasis, TNM stage and urine glucose. Multivariate Cox proportional hazard model showed that six factors were identified to be associated with higher relative-risk ( RR ),including: older age, advanced TNM stage, more severe budding, perineural invasion, less peritumoral-lymphocytic infiltration and urine glucose. Conclusion Age, TNM stage, tumor budding, perineural invasive, peritumoral-lymphocytic infiltration and urine glucose were independent predictors to the prognosis of colorectal carcinoma.