结肠癌预后相关的多因素分析

发布时间：2018-05-02 22:39

本文选题：结肠癌 + 临床特征　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]综合分析患者性别、年龄、肿瘤发生部位、临床分期、肿瘤分化程度、手术方式、辅助化疗、外周血T淋巴细胞亚群水平与结肠癌预后的关系,并尝试建立一个纳入了免疫指标的更加合理、完善的结肠癌预后评价体系。[方法]以病案室查阅病历的方式收集2002年1月-2011年12月期间在云南省肿瘤医院初诊并接受外科手术、术后组织病理确诊为结肠腺癌的505例患者的临床病历资料,通过电话随访共随访到325例结肠癌患者的术后生存情况,采用卡方检验、单因素对数秩检验、C0X回归分析,探讨性别、年龄、肿瘤发生部位、临床分期、肿瘤分化程度、手术术式(根治性手术或姑息性手术)、辅助化疗与否、外周血T淋巴细胞亚群水平(CD3~+T细胞、CD4~+T细胞、CD8+T细胞、CD4~+/CD8+比值)与结肠癌预后的关系。[结果]1. 505例结肠癌患者的术后1、3、5年生存率分别为:83. 7%、71.1%、65. 1%。2. CD3~+、CD4~+、CD8+T细胞亚群表达水平在不同年龄、临床分期患者中有显著差异;而在不同性别、肿瘤部位、分化程度患者之间均无显著差异。3.临床分期晚、组织分化程度差、未进行结肠癌根治术及术后辅助化疗的结肠癌患者术后总生存时间较短,本研究结果与既往国内外报道一致。4.本回顾性研究还提示:患者外周血中CD4~+T淋巴细胞亚群水平越低,其术后总生存时间越短;而CD3~+、CD4~+、CD8+T细胞亚群水平以及CD4~+/CD8+比值变化均与患者总生存时间无关。[结论]临床分期、分化程度、手术方式、辅助化疗与否、外周血中CD4~+T淋巴细胞亚群水平均是结肠癌患者的独立预后因素,上述各指标联合评价有助于更为全面、合理地进行结肠癌预后判断及治疗指导。
[Abstract]:[Objective] to analyze the relationship between the sex, age, the site of the tumor, the stage of the tumor, the degree of differentiation, the mode of operation, the adjuvant chemotherapy, the relationship between the level of T lymphocyte subsets in peripheral blood and the prognosis of colon cancer, and try to establish a more reasonable and perfect prognostic evaluation system for colon cancer. The medical records were used to collect the clinical records of 505 patients with colonic adenocarcinoma diagnosed in Yunnan Tumor Hospital, Yunnan Province, in December January 2002, and were followed up to 325 cases of colon cancer by telephone follow up. The card test and single factor logarithmic rank test were used. C0X regression analysis to explore the relationship between sex, age, site of tumor, clinical stage, degree of tumor differentiation, surgical operation (radical surgery or palliative surgery), adjuvant chemotherapy or not, the relationship between the peripheral blood T lymphocyte subsets (CD3~+T cells, CD4~+T cells, CD8+T cells, CD4~+/CD8+ ratio) and the prognosis of colon cancer. [results]1. 505 cases of colon cancer) The survival rate of 1,3,5 years after operation was 83.7%, 71.1%, 65. 1%.2. CD3~+, CD4~+, CD8+T cell subsets in different age and clinical stages, but there was no significant difference between the different sex, tumor site and differentiation degree of patients with.3. clinical stage, poor differentiation of tissue, and no radical colon cancer radical treatment. The total survival time after operation and postoperative adjuvant chemotherapy was shorter. The results of this study were consistent with the previous reports in China and abroad. The.4. retrospective study also suggested that the lower the level of CD4~+T lymphocyte subsets in peripheral blood, the shorter the total survival time of the patients, and the changes of CD3~+, CD4~ +, CD8+T cell subsets and the CD4~+/CD8+ ratio. It is not related to the total survival time of the patients. [Conclusion] the clinical stage, the degree of differentiation, the mode of operation, adjuvant chemotherapy or not, the average CD4~+T lymphocyte subgroup water in peripheral blood is an independent prognostic factor in the patients with colon cancer. The combined evaluation of these indexes will help to make a more comprehensive and reasonable prognosis and treatment guidance for colon cancer.

【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.35

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