Ⅱ、Ⅲ期结肠癌患者根治术后肿瘤转移复发的相关因素分析

Analysis of the relevant factors of tumor metastasis and recurrence in stage Ⅱ or Ⅲ colon cancer patients underwent radical operation

目的探讨Ⅱ、Ⅲ期结肠癌患者根治术后肿瘤转移复发的相关影响因素。方法以我院2008年2月至2010年5月收治并经根治术治疗的78例Ⅱ、Ⅲ期结肠癌患者作为研究对象,通过患者的随访资料对其转移复发情况进行统计,并对经单因素分析后有意义的因素进行Cox模型多因素分析。结果患者术后转移复发与吸烟情况、原发部位、是否为双原发癌、淋巴结转移、癌结节、肿瘤分化程度、肿瘤形态、脉管瘤栓、TMN分期、T分期、化疗方案、术前CEAb、术后CEAb、术前CA19-9b、术后CA19-9b有密切的关系(P<0.05);经Cox模型多因素分析显示,原发部位、淋巴结转移、肿瘤形态、TMN分期、化疗方案、术前CEAb、术前CA19-9b是转移复发的主要影响因素。结论Ⅱ、Ⅲ期结肠癌患者根治术后肿瘤的复发转移受多种因素的共同影响,其中以淋巴结转移、TMN分期以及组织学类型等密切相关,临床对患者预后的判断需结合各种因素综合考虑。

Objective To explore the relevant influence factors of tumor metastasis and recurrence in pa-tients with stageⅡorⅢcolon cancer after the radical operation. Methods Seventy eight patients with stageⅡorⅢcolon cancer who had underwent radical operation in our hospital from February 2008 to May 2010 were enrolled. Tu-mor metastasis and recurrences of all patients were analysed by reviewing their follow-up data. Multi-factors Cox model analysis was carried out among the significant factors proved by single factor analysis. Results The metasta-sis and recurrence of tumor was closely connected to smoking, primary site of tumor, whether it was double primary cancer or not, lymph node metastasis, cancer nodules, degree of tumor differentiation, tumor shape, LVSI, TMN stag-ing, T staging, chemotherapy regimens, preoperative carcinoembryonic antigen （CEAb）, postoperative CEAb, preopera-tive tumor markers （CA19-9b） and postoperative CA19-9b （P〈0.05）, among which the primary site of tumor, lymph node metastasis, tumor shape, TMN staging, chemotherapy regimens, preoperative CEAb and preoperative CA19-9b were the major influence factors by multi-factors Cox model analysis. Conclusion There were many relevant influ-ence factors of tumor metastasis and recurrence in patients with stageⅡorⅢcolon cancer after the radical operation, among which the lymph node metastasis, TMN staging and histological type were the most important ones. We should consider all these factors before we came to the prognosis of patients.