结直肠癌患者脉管癌栓与预后的相关性分析

摘要

目的 探讨结直肠癌患者脉管癌栓和临床病理特征及肿瘤组织中KRAS基因突变情况的关系及其对结直肠癌预后的意义.方法 回顾性分析2011-2014年182例结直肠癌患者术后的临床病理资料并随访.结果 结直肠癌脉管癌栓阳性的患者共45例,其与淋巴结转移、病理分化程度、肝转移、神经浸润及术前CEA、CA199水平有关(P<0.05),而与患者年龄、性别、肿块大小、浸润深度和病理类型无相关性.脉管癌栓阳性患者的3年生存率为51.1%,显著低于阴性患者61.3%(P<0.05).脉管癌栓阳性合并KRAS基因突变患者与脉管癌栓阳性患者的3年生存率差异无统计学意义(P>0.05).结论 结直肠癌脉管癌栓降低患者3年生存率影响患者预后,合并KRAS基因突变生存率与其相近.%Objective To investigate the relationship between vessel cancer embolus with other clinicopathological features and tumor tissue KRAS gene mutation in the patients with colorectal cancer and its significance to colorectal cancer prognosis.Methods The postoperative clinicopathological data in 182 patients with colorectal cancer during 2011-2014 were retrospectively analyzed and the patients were followed up.Results Forty-five cases showed vessel cancer embolus positive of colorectal cancer,which had the rrelationship with the lymph node metastasis,pathological differentiation degree,liver metastasis,nerve infiltration and increase of CEA and CA199 levels,while had no relationship with the age,sex,tumor size,infiltration depth and pathological type.The 3-year survival rate was 51.1% in the vessel cancer embolus positive group,which was significantly lower than 61.3% in the negative group (P<0.05).However,the 3-year survival rate had no statistically significant difference between the vessel cancer embolus positive complicating KRAS gene mutation group and the vessel cancer embolus positive group(P>0.05).Conclusion Vessel cancer embolus decreases the 3-year survival rate and affects the prognosis in the patients with colorectal cancer.The survival rate in complicating KRAS gene mutation is similar.