CT诊断壁外血管侵犯联合CA19-9对Ⅲ期结肠癌病人预后预测价值研究

发布时间：2018-02-23 17:41

  本文关键词： 结肠肿瘤 壁外血管侵犯 CA- 无病生存　出处：《中国实用外科杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的探索增强多排螺旋CT(ce MDCT)诊断结肠癌壁外血管侵犯(EMVI)预测病人3年无病生存(DFS)的价值。方法收集北京大学人民医院胃肠外科2009年2月至2013年12月间接受根治性手术切除并经病理学检查证实的90例原发性结肠癌病人的临床病理资料及术前影像学资料。根据术前ce MDCT影像特征确定结肠癌EMVI阳性为结肠癌块直接侵犯至结肠壁外血管腔内。Kaplan-Meier法比较结肠癌病人3年DFS差异;Cox比例风险模型单因素、多因素分析结肠癌病人3年DFS的相关因素及独立预测因素;卡方检验比较结肠癌病人的复发转移发生率。结果根据美国癌症联合委员会(AJCC)的标准,经病理诊断为Ⅲ期的90例结肠癌病人纳入本回顾性研究。Cox多因素模型分析发现,ce MDCT诊断EMVI阳性(HR=3.266,95%CI 1.648~7.173,P=0.003)和术前血清CA19-9≥37 k U/L(HR=2.229,95%CI 1.040~4.776,P=0.039)是预测Ⅲ期结肠癌病人3年DFS的独立危险因素。EMVI阳性组及阴性组的3年DFS分别为52.8%和81.5%,二者差异具有统计学意义(P0.05);EMVI阴性联合血清CA 19-9正常的病人3年复发转移发生率为10.5%,显著低于EMVI阳性联合血清CA19-9升高的病人(54.5%,P0.05)。结论 CT诊断EMVI阳性和术前血清CA19-9升高是Ⅲ期结肠癌术后3年DFS的独立预后危险因素,可此对Ⅲ期结肠癌可进行更准确的风险分层。
[Abstract]:Objective to explore the value of enhanced multislice spiral CT(ce (MDCT) in the diagnosis of extramural vascular invasion of colon cancer (EMVI) in predicting the 3-year disease-free survival of patients. Methods from February 2009 to December 2013, the indirect radical resection of gastrointestinal surgery in the people's Hospital of Peking University was collected. Clinicopathological data and preoperative imaging data of 90 patients with primary colon cancer proved by surgical resection and pathological examination. According to the features of preoperative ce MDCT imaging, it was confirmed that the positive EMVI of colon cancer was the direct invasion of colon cancer to colon. Kaplan-Meier method was used to compare 3-year DFS difference in colon cancer patients. Multivariate analysis of the related factors and independent predictive factors of 3-year DFS in colon cancer patients, chi-square test was used to compare the recurrence and metastasis rate of colon cancer patients. 90 patients with colon cancer diagnosed by pathology in stage 鈪，

本文编号：1527023