结肠癌临床病理因素与复发转移的相关性研究

Study on the correlation of clinicopathologic factors with recurrence in colon cancer

目的：探讨结肠癌根治术后复发转移的相关因素。方法：应用单因素和多因素分析方法，回顾性分析1990年1月～1999年12月282例结肠癌根治术病例的临床病理因素。结果：复发转移率16．3％（46／282），复发转移在术后2年内出现者占71．7％（33／46），3年内出现者占89．1％（41／46）。最常见的远处转移位置是肝（56．8％，21／37）。单因素分析显示，结肠癌患者的Dukes，分期、淋巴结转移、肠壁浸润深度、大体类型与复发转移有关。多因素分析显示，结肠癌的淋巴结转移、肠壁浸润深度是复发转移独立预后因素。结论：结肠癌根治术后最常见的远处转移位置是肝，淋巴结转移、浸润深度是影响结肠癌术后复发转移独立预后因素。

OBJECTIVE： To investigate the clinicopathologic factors related with recurrence following curative surgery for colon cancer. METHODS： The clinicopathologic factors and follow-up data of 282 cases of colon cancers after surgical treatment from 1991 to 1999 were retrospectively analyzed using univariate and multivariate method. RESULTS： The overall recurrence rate was 16.3% （46/282）. Within two years after the operation, 74. 1 percent of recurrences were detected. The percentages at three years were 92.2 percent. The most common site of distant metastasis was the liver（56.8%,21/37）. Univariate analysis showed that Dukes＇ stage, lymph node metastasis, depth of bowel wall invasion and gross findings were significantly associated with recurrence after operation. Multivariate analysis showed that lymph node metastasis and depth of bowel wall invasion were independent prognostic factors for recurrence after operation. CONCLUSION： The most common site of distant metastasis following curative surgery for colon cancer is the liver. Lymph node metastasis and depth of bowel wall invasion are the most important prognostic factors for recurrence.