浸润深度与结直肠癌患者临床特征及预后的关系

Relationship between the invasion depth of colorectal cancer and the clinical characteristics and prognosis of patients

目的探讨肿瘤浸润深度与结直肠癌患者临床特征及预后的关系。方法收集122例结直肠癌患者的临床资料,根据肿瘤浸润深度进行分期,其中,T1~2期患者和T3~4期患者各61例。分析浸润深度与结直肠癌患者临床特征的关系。结直肠癌患者死亡的影响因素采用Logistic回归模型进行分析。结果肿瘤直径≤5 cm、无器官转移、无淋巴结转移、无血管侵犯、癌胚抗原(CEA)水平正常、糖类抗原CA19-9(CA19-9)水平正常、无神经或脉管浸润、TNM分期早的结直肠癌患者的浸润深度明显浅于肿瘤直径﹥5 cm、有器官转移、有淋巴结转移、有血管侵犯、CEA水平异常、CA19-9水平异常、有神经或脉管浸润、TNM分期晚的结直肠癌患者(P﹤0.01)。单因素分析结果显示:年龄≥60岁、肿瘤直径﹥5 cm、有器官转移、有淋巴结转移、有血管侵犯、有神经或脉管浸润、浸润深度分期为T3~4期、TNM分期为Ⅲ期的结直肠癌患者的病死率均明显高于年龄﹤60岁、肿瘤直径≤5 cm、无器官转移、无淋巴结转移、无血管侵犯、无神经或脉管浸润、浸润深度分期为T1~2期、TNM分期为Ⅰ期的结直肠癌患者(P﹤0.05)。多因素分析结果显示:年龄≥60岁、有器官转移、有血管侵犯、浸润深度分期为T3~4期、有神经或脉管浸润、TNM分期为Ⅲ期均是结直肠癌患者死亡的独立危险因素(P﹤0.05)。结论浸润深度与结直肠癌患者的疾病严重程度及预后有关,可根据浸润深度对治疗及术后恢复进行有效干预。

Objective To investigate the relationship between the invasion depth of colorectal cancer and the clinical characteristics and prognosis of patients. Method The clinical data of 122 patients with colorectal cancer were selected.According to their depth of invasion, there were 61 patients in stage T1-2 and 61 patients in stage T3-4. The relationship between invasion depth and clinical characteristics was analyzed. The factors affecting the death of patients with colorectal cancer were analyzed by Logistic regression. Result The stage of invasion depth in patients with tumors diameter ≤5 cm, no metastasis of organs, no lymph node metastasis, no vascular invasion, normal carcinoembryonic antigen(CEA)level, normal carbohydrate antigen 19-9(CA19-9) level, no nerve or vascular invasion, early stage of TNM stage was significantly shallower than that in patients with tumors diameter >5 cm, metastasis of organs, lymph node metastasis, vascular invasion, abnormal CEA level, abnormal CA19-9 level, nerve or vascular invasion and late stage of TNM stage(P<0.01). The results of univariate analysis showed that the mortality of patients with age ≥60 years, tumor diameter > 5 cm,organ metastasis, lymph node metastasis, vascular invasion, nerve or vascular invasion, the depth of invasion in T3-4 stage and TNM staging in stage Ⅲ wad significantly higher than that of patients with age <60 years, tumor diameter ≤5 cm, no organ metastasis, no lymph node metastasis, no vascular invasion, no nerve or vascular invasion, the depth of invasion in T1-2 stage, and TNM staging in stage Ⅰ(P<0.05). The results of multivariate analysis age ≥60 years, organ metastasis, vascular invasion, invasion depth in stage T3-4, nerve or vascular invasion and TNM staging in stage Ⅲ were all independent risk factors affecting the death in patients with colorectal cancer(P<0.05). Conclusion The invasion depth of patients with colorectal cancer is related to the severity of disease and prognosis. Effective intervention can be made for treatment and postoperative recovery according to the invasion depth of patients with colorectal cancer.