腹腔镜直肠癌根治性手术患者术前Naples评分与预后的相关性分析

Correlation analysis between preoperative Naples score and prognosis in patients undergoing laparoscopic radical surgery for rectal cancer

目的 探讨腹腔镜直肠癌根治性手术患者术前Naples评分与预后的相关性。方法 选取2010年1月至2020年6月在庐江县中医院行腹腔镜直肠癌根治性手术的98例患者作为研究对象,根据术前Naples评分分为0分组(n=25)、1~2分组(n=50)、3~4分组(n=23),比较三组患者的临床资料和随访结果,并通过多因素Cox回归分析腹腔镜直肠癌根治性手术患者预后不良的独立危险因素。结果 Naples 3~4分组患者的体重指数、术后3年无瘤生存率、术后3年总生存率均显著低于Naples 0分组(均P<0.05)。Naples 3~4分组患者术后住院天数显著长于Naples 0分组(P<0.05),TNM分期为Ⅲ期、组织分化程度为低分化、淋巴结转移的比例、血癌胚抗原水平均显著高于Naples 0分组(P<0.05)。多因素Cox回归分析结果表明,分化程度为低分化、有淋巴结转移、Naples评分均为3~4分是患者预后不良的独立危险因素(均P<0.05)。结论 术前Naples评分为3~4分是腹腔镜直肠癌根治性手术患者预后不良的独立危险因素之一,可参考该评分制定治疗方案和随访计划。

Objective To analyze the correlation analysis between preoperative Naples score and prognosis in patients undergoing laparoscopic radical surgery for rectal cancer.Method 98 patients undergoing laparoscopic radical surgery for rectal cancer in Lujiang County Hospital of Traditional Chinese Medicine from January 2010 to June 2020 were selected for the study subjects and divided into 0 score group(n=25),1-2 score group(n=50)and 3-4 score group(n=23)according to the preoperative Naples score.The clinical data and followup result were compared among the three groups of patients,and the independent risk factors for poor prognosis in all patients undergoing laparoscopic radical surgery were explored through multivariate COX regression analysis.Result The body mass index,3year tumor free survival rate and 3year overall survival rate in Naples 34 score group were significantly lower than those in Naples 0 score group(all P<0.05),the hospital days after surgery was significanty longer than Naples score 0 group,and the proportions of TNM stageⅢ,poor tissue differentiation,lymph node metastasis,the level of carcinoembryonic antigen were significantly higher than those in Naples 0 score group(all P<0.05).Multivariate Cox regression analysis showed that low differentiation,lymph node metastasis,and Naples score of 34 score group were the independent risk factors for poor prognosis(all P<0.05).Conclusion For patients undergoing laparoscopic radical surgery for rectal cancer,preoperative Naples score of 3-4 score was an independent risk factor for poor prognosis,and this score could help to develop treatment and followup plans.