影响进展期大肠癌切除术后长期生存的高危因素分析

High risk factors of death after resection of advanced large intestinal cancer

目的 探讨影响进展期大肠癌切除术后长期生存的高危因素。方法 对 117例进展期大肠癌术后病人的临床和病理学特征进行回顾性研究。结果 平均随访 8.5年 ,淋巴结转移 ,肿瘤广泛坏死和神经囊膜浸润与不良的预后有关。多元回归分析提示淋巴结转移 ,肿瘤坏死和神经囊膜浸润单独与长期生存有关。单变量分析示年龄、性别、症状持续时间、肿瘤位置、肿瘤大小、肠梗阻、肿瘤分化程度、粘蛋白、血管浸润、肿瘤肠管外围浸润的程度等因素与长期生存关系不大。结论 影响进展期大肠癌切除术后长期生存的主要因素是淋巴结转移。

Objective To study the high risk factors of death after resection of advanced large intestinal cancer. Methods The clinical and pathologic features of 117 cases of advanced large intestinal cancer who underwent curative surgery in our hospital were studied retrospectively, including age, gender, symptom duration, bowel obstruction, tumor site, tumor size, degree of tumor differentiation, mucin, tumor necrosis, lymphatic infiltration, perineurial invasion, vascular invasion, tumor margin and bowel wall invasion. A median follow up period of 8.5 years was made. Lymphatic nodes metastasis, extensive necrosis and perineurial invasion were significant factors related to poor prognosis. Multivariate regression analysis revealed that lymphatic nodes metastasis, tumor necrosis and perineurial invasion were independently related to long term survival. Univariated analysis indicated that age, gender, symptom duration, tumor size, bowel obstruction, degree of tumor differentiation, mucin, lymphatic infiltratration, vascular invasion, tumor margin and bowel wall invasion were not significantly related to long term survival. Conclusion The main high risk factors of advanced large intestinal cancer related to long term survival are Lymphatic nodes metastasis, tumor necrosis, and perineurial invasion.