血管侵犯与结肠癌预后的相关性研究

The study of venous invasion and its prognostic significance for colon cancer

目的探讨血管侵犯与结肠癌预后的相关性。方法收集2000年1月至2001年12月在中山大学肿瘤医院行根治性手术的结肠癌患者共136例,将入选病例的病理蜡块重新切片进行血管侵犯的检测,分析其与预后的关系。结果平均每名患者送检蜡块数为3.6,全组血管侵犯阳性率为43.4%,全组总的术后1、3、5年生存率分别为95.6%、86.8%、79.0%,其中伴有血管侵犯组分别为89.6%、74.6%和62.1%,无血管侵犯组分别为100%、96.1%和91.8%。血管侵犯是影响结肠癌术后生存的不良预后因素(P=0.021),壁内血管侵犯、壁外血管侵犯、壁内外血管均侵犯3组术后5年生存率分别为65.0%、66.0%、50.0%,均低于无血管侵犯组(P值均<0.05),但3组间术后生存率无统计学差异(P值均>0.05)。V1、V2、V3血管侵犯术后5年生存率分别为74.4%、61.9%、41.7%,均低于V0,且V3组术后生存率较V1组低(P值均<0.05)。结论血管侵犯是结肠癌独立的不良预后因素,血管侵犯越严重,患者的预后越差。

Objective To investigate the correlation between venous invasion and the prognosis of colon cancer. Methods The clinicopathologic and follow-up data of 136 patients with colon cancer,underwent radical resection from Jan. 2000 to Dec. 2001, were analyzed retrospectively. The slides were stained with HE stain and elastic tissue stain for microscopic examination. Results The average number of blocks for each specimen was 3.6, venous invasion was found in 43.4% of the 136 patients. The overall survival rates of 1,3,5-year were 95.6%,86.8% and 79.0% ,in positive venous invasion group they were 89.6%, 74.6% and 62.1% respectively, in negative venous invasion group were 100%,96.1% and 91.8% respectively. Multivariate analysis showed that venous invasion was an adverse prognostic factor for colon cancer （ P =0. 021）. The 5-year survival rates in intramural venous invasion,extramural venous invasion,both intramural and extramural venous invasion group were 65.0% ,66.0% and 50.0% respectively,which were lower than negative venous invasion group （ P 〈0.05） ,but the difference was not significant among these three groups（ P 〉0.05）. The 5-year survival rates in V1 , V2 , V3 group were 74.4% ,61.9% and 41.7% respectively,which were lower than V0 group,and V3 group was lower than V1 group（ P 〈0.05）. Conclusion Venous invasion by tumor is an adverse prognostic factor for colon cancer. The severer venous invasion is,the worse prognosis the patients are.