1829例结直肠癌患者的临床病理特征及预后分析

Clinicopathological features and prognosis of 1829 patients with primary colorectal cancer

目的探讨结直肠癌的临床病理特征和预后。方法应用SPSS10.0软件对1991年1月至2002年12月间经手术和病理确诊、且随访资料完整的1829例结直肠癌患者的临床资料进行统计分析,并通过Cox回归模型,确立影响预后的独立因素。结果1829例结直肠癌患者的平均生存时间为76.8个月,5年生存率56.9%。单因素分析结果显示年龄、出现症状的时间、肿瘤部位、手术性质、病理类型、肿瘤直径、原发肿瘤侵犯深度、淋巴结转移、远处转移和Dukes分期与预后相关。多因素回归分析显示肿瘤部位、手术性质、病理类型、肿瘤直径、原发肿瘤侵犯深度、淋巴结转移和Dukes分期是影响结直肠癌患者术后生存的独立因素。结论应加强普查和早诊的意识,早期发现、早期诊断和治疗结直肠癌,最大限度地改善患者的生存状况。

Objective To evaluate the relationship between the clinicopathologic features and prognosis of colorectal cancer. Methods From January 1991 to December 2002,clinical data of 1829 patients who had been histologically proven to suffer from colorectal adenocarcinoma were statistically analyzed using a model of Cox with SPSS 10.0 software,the effect of independent factor on prognosis was determined. Results The mean survival time of 1829 colorectal cancer patients was 76.8 months and the overall 5 year survival rate was 56.9%. Univarite analysis showed that the predictors of survival in colorectal cancer patients were age,the onset time,tumor location,operative types (radical resection or non radical resection),histological type,diameter of the tumors,depth of tumor invasion,lymphatic invasion,distant metastases and Dukes staging. Multivariate analysis showed that only tumor location,radical resection,histological type,diameter of the tumors,depth of tumor invasion,lymphatic invasion and Dukesstaging were independent factors. Conclusion Early diagnosis and early treatment of colorectal cancer can achieve maximal improvement of survival rate and the quality of life.