结直肠癌患者胆囊切除术后的相关危险因素

Analysis of risk factors of patients with colorectal cancer complicated with cholecystectomy

目的分析结直肠癌并胆囊切除术后患者的实验室指标及病理特征。方法将收治的结直肠癌合并胆囊切除术后患者57例作为病例组、同期收治的单纯结直肠癌患者101例为对照组,收集两组患者的一般资料[年龄、性别、体质量指数(BMI)、高血压、糖尿病、胆囊相关手术史]、实验室检查资料[血胆汁酸、甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原(CA)系列(CA125、CA15-3、CA72-4、CA242、CA19-9)]及病理学资料[肿瘤的部位、分期、浸润深度、远处转移、淋巴结转移、肿瘤蛋白53(P53)、是否为错配修复蛋白缺失(dMMR)结直肠癌],比较两组患者实验室指标及病理学资料的差异,采用多因素logistic分析结肠癌合并胆囊切除术后患者相关危险因素。结果实验组患者平均年龄、女性比例、糖类抗原19-9(CA19-9)阳性率、糖类抗原242(CA242)阳性率、人类表皮生长因子受体2(HER2)阳性率、淋巴结转移率高于对照组,差异有统计学意义(P<0.05),多因素logistic分析提示性别、年龄是胆囊切除术后患者并结直肠癌的独立危险因素(P<0.05)。结论结直肠癌合并胆囊切除术后患者易发生淋巴结转移,且女性患病风险高于男性,提示预后差,复发风险高。

Objective To analyze the laboratory examination data and pathological characteristics of patients with colorectal cancer complicated with cholecystectomy.Methods A total of 57 patients with colorectal cancer complicated with cholecystectomy were selected as an experimental group,and 101 patients only with colorectal cancer admitted at the same period were selected as a control group.The data of two groups of the patients were collected,including general data[age,gender,body mass index(BMI),hypertension,diabetes and gallbladder-related surgery history],laboratory examination data[blood bile acid,alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen(CA)series(including CA125,CA15-3,CA72-4,CA242,and CA19-9)]and pathology data[tumor site,stage,infiltration depth,distant metastasis,lymph node metastasis,tumor protein 53(P53)and whether mismatch repair protein deficiency(dMMR)was in colorectal cancer].The differences in laboratory indicators and pathological data were compared between two groups of the patients.Multivariate logistic analysis was performed to identify relevant risk factors for the patients with colorectal cancer complicated with cholecystectomy.Results The average age,female proportion,CA19-9 positive rate,CA242 positive rate,HER2 positive rate and the rate of lymph node metastasis of experimental group were higher than those of control group(P<0.05).Multivariate logistic analysis suggested that gender and age were independent risk factors for the patients with colorectal cancer complicated with cholecystectomy(P<0.05).Conclusion The patients colorectal cancer complicated with cholecystectomy are more prone to have lymph node metastasis,among them,women have a higher risk of illness than men,indicating poor prognosis and high risk of recurrence.