T2NOM0期结直肠癌339例预后分析

摘要

Objective To find T2N0M0 colorectal cancer patients at high risk for relapse or metastasis.Methods From January 1993 to December 2014,339 patients with histologically confirmed stage T2N0M0 primary colorectal cancer treated by radical surgery with complete clinical follow-up data were enrolled into this study.Survival rates were calculated using Kaplan-Meier method,and survival cures were compared using the Log-rank test.Cox proportional hazards model was used to analyze the significant factors defined in univariate test.Results The 5-year and 10-year overall survival rates were 83.0％ and 68.9％,respectively.Male gender,old age,lymphovascular involverment,perineural invasion,poor differentiation and invasive micropapillary carcinoma were associated with low cancer-specific survival rates in Kaplan-Meier analysis.Multivariate analyses revealed male gender,old age,lymphovascular involverment,poor differentiation and invasive micropapillary carcinoma as significant independent factors predicting poor prognosis.Conclusions Male gender,old age,lymphovascular involvement,poor differentiation and invasive micropapillary carcinoma are risk factors predicting poor prognosis for T2N0M0 colorectal patients.%目的 探讨影响T2N0M0期结直肠癌的预后危险因素.方法 收集1993年1月至2014年12月收治的经根治性手术切除的T2N0M0期结直肠癌患者的临床资料,选取其中随访资料完整的339例进行回顾性分析,应用Kaplan-Meier法计算生存率,用Log-rank法行生存率比较,用Cox模型做多因素分析,找出独立的预后影响因素. 结果 患者的5年、10年总生存率分别为83.0％、68.9％,与预后相关的单因素为性别、年龄、脉管浸润、神经侵犯、分化不良和含有浸润性微小乳头状癌成分.多因素分析结果显示,性别、年龄、脉管浸润、分化不良和微小浸润乳头状癌成分是影响预后的独立因素.结论 性别、年龄、脉管浸润、分化不良和浸润性微小乳头状癌成分是影响预后的独立因素.