Ⅲ期结肠癌患者根治术后复发的影响因素分析

Factors Influencing Radical Recurrence in Patients with Stage Ⅲ Colon Cancer

目的分析Ⅲ期结肠癌患者根治术后复发的影响因素。方法选择Ⅲ期结肠癌患者74例作为研究对象,入选患者均行结肠癌根治术治疗,并进行长期随访。根据5年随访结果将患者分为复发组和未复发组,收集患者一般临床资料,采用单因素和多因素Logistic回归分析Ⅲ期结肠癌患者根治术后复发的影响因素。结果两组年龄、性别、肿瘤部位、肿瘤组织类型、有无梗阻发生、手术范围比较,差异无统计学意义(P>0.05);复发组中淋巴结转移、未行辅助化疗、肿瘤直径>5.0 cm、术前CEA水平>5.0 ng/mL及肿瘤中、高分化程度占比率明显高于未复发组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,淋巴结转移、未行辅助化疗、肿瘤直径>5.0 cm、术前CEA水平>5.0 ng/mL及肿瘤中、高分化程度均是结肠癌根治术后患者复发的独立危险因素。结论淋巴结转移、未行辅助化疗、肿瘤直径>5.0 cm、术前CEA水平>5.0 ng/mL及肿瘤中、高分化程度均是结肠癌患者根治术后复发的独立危险因素,应采取针对性措施,降低肿瘤复发率。

Objective To analyze the influencing factors of radical surgical recurrence in patients with stageⅢcolon cancer.Methods 74 patients with stageⅢcolon cancer were selected as the study subjects.All selected patients were treated with radical colon cancer and underwent long-term follow-up.Patients were divided into relapsed and unrelapsed groups based on the 5-year follow-up results,general clinical data were collected,and factors of univariate and multivariate Logistic regression were used to analyze the effects of radical recurrence in stageⅢcolon cancer patients.Results Age,sex,tumor site,tumor tissue type,obstruction,surgical range of the 2 groups had no statistically significant difference(P>0.05);In the relapsed group,lymph node metastasis,no adjuvant chemotherapy,tumor diameter>5.0 cm,preoperative CEA>5.0 ng/mL and the proportion of high differentiation were significantly higher than in the unrelapsed group,the differences were statistically significant(P<0.05);Multivariate Logistic regression analysis revealed that,Lymph node metastasis,no adjuvant chemotherapy,tumor diameter>5.0 cm,preoperative CEA>5.0 ng/mL and high degree of differentiation were independent risk factors for recurrence in patients with radical colon cancer.Conclusion Lymph node metastasis,no adjuvant chemotherapy,tumor diameter>5.0 cm,preoperative CEA>5.0 ng/mL and high differentiation are independent risk factors for recurrence in patients with radical colorectal cancer,and targeted measures should be taken to reduce the rate of tumor recurrence.