直肠癌根治术病检淋巴结数目与患者预后关系分析

发布时间：2018-07-18 09:26

【摘要】：目的:直肠癌(rectual cancer)是高发恶性肿瘤,预后差。本研究主要探讨直肠癌根治术病检淋巴结数目与患者预后的关系分析。方法:回顾性分析337例直肠癌患者的临床资料,依淋巴结清扫总数共分为5组,分别为l~6枚组、7~11枚组、12~16枚组、17~21枚组和22枚组,用应用Kaplan-Meier方法计算生存率,对可能影响患者预后的因素采用Log-rank检验进行单因素分析,并用COX回归模型进行多因素分析,以筛选出独立的预后因素。并分析病检淋巴结数生存率。结果:337例患者总的中位生存期(overall survival,OS)为24个月,术后1年、2年、3年生存率分别为:96%、91.3%、85%。3年生存率随着病检淋巴结数目的增多而升高。多因素分析显示,肿瘤分化程度、肿瘤分期、淋巴结转移数、淋巴结检出数是影响患者预后的独立影响因素,与患者预后相关。单因素分析显示:直肠癌患者的预后与淋巴结检出数目有关(P0.05)。结论:肿瘤分化程度、肿瘤分期、淋巴结转移数、淋巴结检出数是影响患者预后的独立因素。直肠癌根治术中,淋巴结清扫总与预后明显相关,在规范化进行根治性手术的前提下,可将淋巴结清扫总数作为判断预后的辅助指标。
[Abstract]:Objective: rectal cancer (rectual cancer) is a high incidence malignant tumor, poor prognosis. The purpose of this study was to investigate the relationship between the number of lymph nodes and prognosis of patients with rectal cancer after radical resection. Methods: the clinical data of 337 patients with rectal cancer were retrospectively analyzed. According to the total number of lymph node dissection, the patients were divided into 5 groups, namely, 6 group (n = 7), 1216 cases (n = 1721) and 22 cases (n = 22). The survival rate was calculated by Kaplan-Meier method. Univariate analysis was performed by Log-rank test and multivariate analysis was carried out by Cox regression model to screen out independent prognostic factors. The survival rate of lymph nodes was analyzed. Results the overall median survival time (overall survival OS) was 24 months. The 1 year, 2 year and 3 year survival rates of 1, 2 and 3 years after operation were 91.3% and 85.3%, respectively. The survival rate increased with the increase of the number of lymph nodes. Multivariate analysis showed that the degree of tumor differentiation, tumor staging, lymph node metastasis and lymph node detection were independent factors affecting the prognosis of the patients, and correlated with the prognosis of the patients. Univariate analysis showed that the prognosis of rectal cancer patients was related to the number of lymph node detection (P0.05). Conclusion: the degree of tumor differentiation, tumor stage, lymph node metastasis and lymph node detection are independent factors influencing the prognosis of patients. In radical resection of rectal cancer, lymph node dissection is obviously related to prognosis. Under the premise of standardized radical operation, the total number of lymph node dissection can be taken as an auxiliary index to judge prognosis.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.37

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