影响T2期直肠癌淋巴结转移因素分析

摘要

目的 研究影响T2期直肠癌淋巴结转移的因素,为T2期直肠癌局部切除选择病例提供参考依据.方法 回顾分析根治性切除的T2期直肠癌淋巴结转移情况,对患者年龄、性别、病程、肿瘤最大直径、肿瘤离肛缘距离、肿瘤直肠位置、肿瘤占肠腔周径、大体类型、组织分型、分化程度、送检淋巴结数量、浸润深度、术前血CEA、术前血CA199、组织ER、组织PR、组织CEA、组织P53等临床病理参数与淋巴结转移情况进行统计分析.结果 T2期直肠癌淋巴结转移率为23.9%(95/398),淋巴结转移与年龄和术前血CEA相关,与组织类型、浸润深度、分化程度、大体类型有关.logistic多因素回归分析结果显示淋巴结转移情况与肿瘤大体及年龄相关.结论 高龄增殖型T2期直肠癌淋巴结转移率相对较低,局部切除可行性较大.%Objective To study the risk factors for lymph node metastasis in T2 stage rectal carcinomas. Methods Consecutive cases of 398 patients with T2 stage rectal cancer with radical surgery were included for retrospective analysis. Clinical and pathological characteristics, including age, gender, tumor site, tumor size, pathological typing, carcinomatous component, grade, depth of invasion, CEA were assessed. Student's t-test, Chi-squared test and logistic regression were used to analyze risk factors for lymph node metastasis. Results The rate of lymph node metastasis was 23.9％ ( 95/398 ). Significant predictors of lymph node metastasis in both univariate and multivariate analysis were typing and age. Depth, carcinomatous component and grade were risk factors for lymph node metastasis according to univariate analysis. Conclusion T2 stage rectal cancer has lower risk of lymph node metastasis in senile and local resection is feasible.