结直肠癌患者预后的危险因素分析
发布时间：2018-09-18 06:44
【摘要】：目的:回顾性分析影响结直肠癌患者预后的相关危险因素,为临床治疗方案的选择提供理论依据,以改善结直肠癌患者的生存状况。材料与方法:本研究选取河北医科大学第四医院外二科自2010年1月至2010年12月行手术治疗的293例结直肠癌患者为研究对象,对符合条件的患者采用病例随访(门诊复查及电话随访),以患者的手术时间为随访起点,截止时间为2016年10月30日或患者的死亡时间。共收集到257例病例资料,失访率12.3%。通过收集患者的临床参数(性别、年龄、吸烟饮酒史、肿瘤家族史、合并肠梗阻穿孔、术前贫血、合并糖尿病)、病理参数(肿瘤部位、肿瘤大小、组织学类型及分化程度、肠壁浸润度、淋巴结转移、远处转移)、肿瘤标记物(癌胚抗原、糖类抗原19-9)及治疗方式(手术方式、新辅助治疗、辅助治疗、围手术期输血),建立EXCEL数据库,运用SPSS21.0统计软件对数据库资料进行统计分析。单因素分析采用Kaplan-Meier法,多因素生存分析采用多因素Cox回归模型进行分析。结果:本研究共收集了257例结直肠癌患者完整资料,其中结肠癌116例,直肠癌患者141例,男性154例,女性103例,年龄:19-86岁,中位年龄:52.5岁。单因素分析发现:术前有无贫血、组织学类型(腺癌、粘液腺癌)及分化(高分化、中分化、低分化)程度、肠壁浸润程度(T1-2、T3-4)、淋巴结转移(N0、N1、N2)、远处转移(M0、M1)、癌胚抗原(5ng/ml、≤5ng/ml)、糖类抗原19-9(27U/ml、≤27U/ml)、手术方式(根治性手术、姑息性手术)在结直肠癌的对比中差异具有统计学意义(P0.05)。进一步多因素分析后发现:癌胚抗原、糖类抗原19-9、淋巴结转移、手术方式在结直肠癌的对比中差异具有统计学意义(P0.05)。结论:癌胚抗原、淋巴结转移、手术方式是影响结肠癌患者预后的独立危险因素;糖类抗原19-9、淋巴结转移是影响直肠癌患者预后的独立危险因素。
[Abstract]:Objective: to analyze the risk factors influencing the prognosis of patients with colorectal cancer and to provide a theoretical basis for the choice of clinical treatment to improve the survival status of patients with colorectal cancer. Materials and methods: 293 patients with colorectal cancer who received surgical treatment from January 2010 to December 2010 in the second Department of the fourth Hospital of Hebei Medical University were selected as the study subjects. The eligible patients were followed up by case (outpatient review and telephone follow-up), with the patient's operative time as the starting point and the deadline of October 30, 2016 or the patient's death time as the starting point. A total of 257 cases were collected and the missing rate was 12.3%. The clinical parameters (sex, age, smoking and drinking history, family history of tumor, complicated with perforation of intestinal obstruction, preoperative anemia, diabetes mellitus), pathological parameters (tumor location, tumor size, histological type and differentiation degree) were collected. EXCEL database was established by intestinal wall invasion, lymph node metastasis, distant metastasis, tumor markers (carcinoembryonic antigen, carbohydrate antigen 19-9) and treatment (operation, neoadjuvant therapy, perioperative blood transfusion). Use SPSS21.0 statistical software to carry on the statistical analysis to the database data. Kaplan-Meier method was used for univariate analysis and multivariate Cox regression model was used for multivariate survival analysis. Results: a total of 257 patients with colorectal cancer were collected, including 116 colon cancer patients, 141 rectal cancer patients, 154 males and 103 females, with a median age of 52.5 years. Univariate analysis showed that there were anemia, histological types (adenocarcinoma, mucinous adenocarcinoma) and differentiation (high, medium and low differentiation) before operation. The degree of invasion of intestinal wall (T1-2n / T3-4), lymph node metastasis (N0 / N1N _ 2), distant metastasis (M0M _ 1), carcinoembryonic antigen (5ng / ml, 鈮，
本文编号：2247099
[Abstract]:Objective: to analyze the risk factors influencing the prognosis of patients with colorectal cancer and to provide a theoretical basis for the choice of clinical treatment to improve the survival status of patients with colorectal cancer. Materials and methods: 293 patients with colorectal cancer who received surgical treatment from January 2010 to December 2010 in the second Department of the fourth Hospital of Hebei Medical University were selected as the study subjects. The eligible patients were followed up by case (outpatient review and telephone follow-up), with the patient's operative time as the starting point and the deadline of October 30, 2016 or the patient's death time as the starting point. A total of 257 cases were collected and the missing rate was 12.3%. The clinical parameters (sex, age, smoking and drinking history, family history of tumor, complicated with perforation of intestinal obstruction, preoperative anemia, diabetes mellitus), pathological parameters (tumor location, tumor size, histological type and differentiation degree) were collected. EXCEL database was established by intestinal wall invasion, lymph node metastasis, distant metastasis, tumor markers (carcinoembryonic antigen, carbohydrate antigen 19-9) and treatment (operation, neoadjuvant therapy, perioperative blood transfusion). Use SPSS21.0 statistical software to carry on the statistical analysis to the database data. Kaplan-Meier method was used for univariate analysis and multivariate Cox regression model was used for multivariate survival analysis. Results: a total of 257 patients with colorectal cancer were collected, including 116 colon cancer patients, 141 rectal cancer patients, 154 males and 103 females, with a median age of 52.5 years. Univariate analysis showed that there were anemia, histological types (adenocarcinoma, mucinous adenocarcinoma) and differentiation (high, medium and low differentiation) before operation. The degree of invasion of intestinal wall (T1-2n / T3-4), lymph node metastasis (N0 / N1N _ 2), distant metastasis (M0M _ 1), carcinoembryonic antigen (5ng / ml, 鈮，
本文编号：2247099
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