早期结直肠癌淋巴结转移潜在危险因素分析

AN ANALYSIS OF POTENTIAL RISK FACTORS FOR LYMPH NODE METASTASIS IN EARLY COLORECTAL CANCER

目的 确定早期结直肠癌(ECC)病人发生淋巴结转移(LNM)的潜在危险因素。方法 收集293例ECC病人的临床和组织病理学资料,进行单因素和多因素分析,探讨其与LNM的关系。结果 单因素分析显示,肿瘤的大体分型(χ^(2)=9.862,P=0.007)、溃疡的存在(χ^(2)=17.168,P<0.001)、黏膜下浸润深度≥1 mm(χ^(2)=36.357,P<0.001)、淋巴血管浸润(χ^(2)=30.985,P<0.001)、周围神经浸润(χ^(2)=22.487,P<0.001)、低分化(χ^(2)=11.400,P=0.003)是LNM的危险因素。多因素分析显示,溃疡的存在(OR=4.664,95%CI=1.635~13.307,P=0.004)、低分化(OR=10.666,95%CI=1.073~106.005,P=0.043)、浸润深度≥1 mm(OR=6.569,95%CI=2.306~18.711,P<0.001)、淋巴血管浸润(OR=8.282,95%CI=2.034~33.723,P=0.003)、周围神经浸润(OR=6.273,95%CI=1.466~26.849,P=0.013)是ECC病人LNM的潜在危险因素。结论 溃疡的存在、黏膜下浸润深度≥1 mm、淋巴血管浸润、周围神经浸润和低分化等是ECC病人LNM的潜在危险因素。

Objective To identify the potential risk factors for lymph node metastasis(LNM) in patients with early colorectal cancer(ECC). Methods The clinical and histopathological data of 293 ECC patients were collected, and univariate and multivariate analyses were performed to evaluate the factors affecting LNM. Results According to the univariate analysis, ge-neral type of tumors(χ^(2)=9.862,P=0.007), presence of ulcer(χ^(2)=17.168,P<0.001), submucosal invasion depth ≥1 mm(χ^(2)=36.357,P<0.001), lymphovascular invasion(χ^(2)=30.985,P<0.001), perineural invasion(χ^(2)=22.487,P<0.001), and poor differentiation(χ^(2)=11.400,P=0.003) were risk factors for LNM. The multivariate analysis showed that presence of ulcer(OR=4.664,95%CI=1.635-13.307,P=0.004), poor differentiation(OR=10.666,95%CI=1.073-106.005,P=0.043), submucosal invasion depth ≥1 mm(OR=6.569,95%CI=2.306-18.711,P<0.001), lymphovascular invasion(OR=8.282,95%CI=2.034-33.723,P=0.003), and perineural invasion(OR=6.273,95%CI=1.466-26.849,P=0.013) were potential risk factors for LNM in ECC patients. Conclusion The presence of ulcer, submucosal invasion depth ≥1 mm, lymphovascular invasion, perineural invasion, and poor differentiation are potential risk factors for LNM in ECC patients.