结直肠癌患者伴发淋巴结转移的相关因素及生存分析

Related factors of lymph node metastasis and survival analysis in patients with colorectal cancer

目的：研究结直肠癌患者伴发淋巴结转移的相关因素,并探索结直肠癌淋巴结转移对患者生存时间的影响。方法：2003年1月~2009年12月在我院确诊为结、直肠癌的患者共780例。采用单因素和Logistic多因素回归分析,研究影响结直肠癌淋巴结转移的相关因素,并用生存分析法分析淋巴结转移对结直肠癌患者预后的影响。结果：780例结直肠癌患者单因素分析结果提示,年龄、吸烟、血清总胆红素水平、CEA、CA19-9、分化程度、病理类型、T分期和M分期均与淋巴结转移相关（均P〈0.05）,进一步行二元非条件Logistic回归分析,得出年龄、血清总胆红素水平和吸烟是影响结直肠癌淋巴结转移的独立相关因素（均P〈0.05）。伴淋巴结转移的结直肠癌患者生存率低于无淋巴结转移患者。结论：结直肠癌患者伴发淋巴结转移的独立相关因素有：年龄、吸烟史和血清总胆红素水平;伴淋巴结转移患者的生存时间明显短于无淋巴结转移的患者。

Objective：To study the related factors of lymph node metastasis in patients with colorectal cancer and explore whether the metastasis influenced patients＇ survival time.Methods：The clinical data of 780 cases with colorectal cancer in the China-Japan Friendship Hospital from January 2003 to December 2009 was analyzed.The associated factors of lymph node metastasis were evaluated by a multiple Logistic regression.Survival analysis was performed for patients with or without lymph node metastasis.Results：Patients with lymph node metastasis were older, more often as smoker, had a higher level of serum total bilirubin level,carcinoembryonic antigen and CA19-9. And they had higher proportion with low degree of differentiation,high degree of infiltration,and an advanced T stage and M stage（P〈0.05）.Multivariate regression analysis suggested that old age,smoking and high level of serum total bilirubin were the independent correlated factors with lymph node metastasis（P〈0.05）.The survival rate of patients with lymph node metastasis was significantly lower than patients without lymph node metastasis.Conclusion：Old age,smoking and high level of serum total bilirubin were the independent risk factors for lymph node metastasis in colorectal cancer patients.The survival rate of patients with lymph node metastasis was significantly lower than patients without lymph node metastasis.