直肠癌脑转移患者预后的影响因素分析

Prognostic factors of brain metastases in patients with colorectal cancer

目的:分析影响直肠癌脑转移患者预后的相关因素。方法:搜集2008年6月-2010年6月期间来我院治疗的100例直肠癌脑转移患者的临床资料,根据治疗方法分为实验组和对照组,实验组为行手术治疗的46例患者,对照组为行放化疗的54例患者。采用Logistic逐步回归分析,分析影响脑卒中瘫痪经手术治疗患者预后的因素。结果:实验组患者的平均生存时间、1年生存率、3年生存率以及5年生存率均优于对照组患者,具有明显差异(P<0.05)。Logistic回归分析示,性别、原发肿瘤组织学分级等因素不是影响直肠癌脑转移患者预后的因素;影响直肠癌脑转移患者预后的相关因素是原发肿瘤直径、脑转移灶数目、血清CEA水平、治疗方法、脑转移灶治疗与否以及年龄。经Logistic回归逐步分析可知,血清CEA水平对患者预后的影响最大(OR=3.743),其次是脑转移灶数目(OR=3.153)、治疗方法(OR=2.946),年龄(>60岁)影响最小(OR=1.900)。结论:影响直肠癌脑转移患者预后的相关因素是原发肿瘤直径、脑转移灶数目、血清CEA水平、治疗方法、脑转移灶治疗与否以及年龄等。及时掌握这些预后影响因素能够显著提高直肠癌脑转移患者生存状况,在临床上具有重要的临床意义。

Objective： To explore the related factors of colorectal cancer patients with brain metastases. Methods：According to the treatment method patients were divided into experimental group and the control group. Results： The mean survival time of patients in the experimental group,1- year survival rate,3- year survival and 5- year survival rate were better than the control group（ P〈0. 05）. Logistic regression analysis showed that gender,primary tumor histological grade were not prognostic factors in patients with brain metastases. Colorectal cancer with brain metastasis related factors were primary tumor diameter,number of brain metastases,serum CEA level,treatment methods,the treatment of brain metastases. Logistic stepwise regression analysis showed that serum CEA levels on prognosis maximum（ OR = 3. 743）,the number of brain metastases（ OR = 3. 153）,treatment（ OR = 2. 946）,age（ 〉60 years）（ OR = 1. 900）. Conclusion： The factors affecting the prognosis of patients with brain metastases of colorectal cancer were primary tumor diameter,number of foci of brain metastases,serum CEA level,treatment methods,the treatment of brain metastases or not,and age.