直肠癌淋巴结转移的相关因素分析

Risk factors for lymph node metastasis of rectal cancer

目的探讨直肠癌淋巴结转移的影响因素。方法将671例手术治疗的直肠癌患者的临床病理资料,采用SPSS10.0统计软件,分析各临床病理因素对直肠癌淋巴结转移的影响。结果全组病例淋巴结转移率为53.2%;患者不同性别和肿瘤位置其淋巴结转移率的差异无统计学意义(均P>0.05),不同年龄、肿瘤大小、大体类型、组织学类型、分化程度及浸润深度者淋巴结转移率的差异有统计学意义(均P<0.01)。上述多因素回归分析得出相关因素与淋巴结转移的密切程度依次为:浸润深度>大体类型>分化程度>组织类型>肿瘤大小>年龄。结论直肠癌淋巴结转移与患者的年龄、肿瘤的大小、大体类型、组织学类型、分化程度及浸润深度相关,浸润深度是影响转移发生的最主要因素。肿瘤越大、浸润越深、分化越差其淋巴结转移率越高。

Objective To investigate the risk factors of lymph node metastasis in rectal cancer . Methods A retrospective analysis was preformed in 671 cases of rectal cancer undergoing surgical resection. The relationship between clinicopathological variables and lymph node metastasis were evaluated by crosstabs and logistic regression in SPSS 10.0 for windows. Results The rate of lymph node metastasis in this series of rectal cancer was 53.2%. After entering crosstabs estimation ,gender and tumor site were not correlated with lymph node metastasis （P〉0.05）; age, tumor size, massive type of the tumor, differentiation degree, histology type and the depths of tumor invasion were proved to be independent risk factors of lymph node metastasis in rectal cancer （P〈0.01）. After entering logistic regression estimation, the order of correlation of lymph node metastasis among all risk factors was： the depths of tumor invasion〉 the massive type 〉 the differentiation degree 〉 histology type〉 tumor size〉age. Conclusion Several clinicopathological factors are correlated with lymph node metastasis in rectal cancer, among which the depth of tumor invasion ranks the first.