结肠癌根治术后复发转移影响因素分析

Multivariate analysis of recurrence and metastasis of colon cancer after radical resection

目的探讨影响结肠癌根治术后复发转移的临床病理因素。方法回顾性分析2006年1月至2007年12月在我院行结肠癌根治术的173例患者的临床病理资料及随访资料。结果全组复发转移率为30.06%(43/173);K-M单因素分析显示淋巴结转移情况、肿瘤浸润深度、肿瘤病理类型、肿瘤分化程度、术前癌胚抗原(CEA)水平、临床分期、术前合并肠梗阻或穿孔与术后复发转移有关;COX多因素分析显示淋巴结转移、肿瘤浸润深度、肿瘤分化程度、CEA水平及术前合并肠梗阻或穿孔是影响术后复发转移的独立因素。结论 淋巴结转移、肿瘤浸润深度、肿瘤分化程度、术前CEA水平升高及术前合并肠梗阻或穿孔是结肠癌根治术后复发转移的危险因素。

Objective To explore the prognostic factors in colon cancer patients treated with radical resection.Methods The clinicopathologic and follow-up data of 173 patients with colon cancer treated with radical resection from Jan 2006 to Dec 2007 were analyzed retrospectively.Results The overall recurrence and metastasis rate was 30.06%.Univariate analysis showed that lymph node involvement,tumor stage,pathologic type,histological differentiation,serum concentration of carcinoembryonic antigen（CEA）,staging location,intestinal obstruction or perforation were correlated to recurrence and metastasis of colon cancer after radical resection.Multivariate analysis showed that lymph node involvement,tumor stage,histological differentiation,serum concentration of CEA,intestinal obstruction or perforation were independent factors affecting the prognosis of colon cancer patients.Conclusion Patients with high serum concentration of CEA,intestinal obstruction or perforation,poor histological differentiation and tumor stage,lymph node involvement have increased risk of recurrence and metastasis.