中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2011年
6期
493-495
,共3页
结直肠肿瘤%肿瘤分期%预后%淋巴结
結直腸腫瘤%腫瘤分期%預後%淋巴結
결직장종류%종류분기%예후%림파결
Colorectal neoplasm%Neoplasm staging%Prognosis%Lymph node
目的 探讨病检淋巴结数目与结直肠癌分期及预后的关系.方法 将567例结直肠癌患者根据术后病检的淋巴结数目分为3个组:≤6枚、7～11枚、≥12枚组,比较各组5年生存率的差别.TNM分期(Ⅰ～Ⅳ期)分别以病检淋巴结数目分为<12枚和≥12枚两组,比较各分期中两组的5年生存率的差别,分析预后相关因素.5年生存率的比较采用Kaplan-Meier法并经Log-rank检验,预后多因素分析采用Cox比例风险模型.结果 567例平均病检淋巴结数目为(16.75±9.88)枚,病检淋巴结数目分别为≤6枚,7～11枚,≥12枚时,结直肠癌5年生存率各为32.3%(21/65),43.8%(53/121),57.7%(220/381),单因素分析表明,病检淋巴结数目≥12枚的结直肠癌5年生存率明显高于其他两组(≤6枚,7～11枚)(P<0.05).<12枚、≥12枚淋巴结两组在Ⅰ期或Ⅳ期的结直肠癌5年生存率无明显差别(89.5%vs.89.1%,8.0%vs.18.2%,P>0.05),而≥12枚淋巴结的Ⅱ期和Ⅲ期5年生存率明显高于<12枚(71.1%vs.32.6%,48.8%vs.30.0%,P<0.05),多因素COX回归模型分析表明,病检淋巴结数目是Ⅱ、Ⅲ期结直肠癌独立的预后因素.结论 病检的淋巴结数目主要通过影响Ⅱ、Ⅲ期的预后与结直肠癌总5年生存率明显相关,是Ⅱ、Ⅲ期结直肠癌独立的预后因素.
目的 探討病檢淋巴結數目與結直腸癌分期及預後的關繫.方法 將567例結直腸癌患者根據術後病檢的淋巴結數目分為3箇組:≤6枚、7～11枚、≥12枚組,比較各組5年生存率的差彆.TNM分期(Ⅰ～Ⅳ期)分彆以病檢淋巴結數目分為<12枚和≥12枚兩組,比較各分期中兩組的5年生存率的差彆,分析預後相關因素.5年生存率的比較採用Kaplan-Meier法併經Log-rank檢驗,預後多因素分析採用Cox比例風險模型.結果 567例平均病檢淋巴結數目為(16.75±9.88)枚,病檢淋巴結數目分彆為≤6枚,7～11枚,≥12枚時,結直腸癌5年生存率各為32.3%(21/65),43.8%(53/121),57.7%(220/381),單因素分析錶明,病檢淋巴結數目≥12枚的結直腸癌5年生存率明顯高于其他兩組(≤6枚,7～11枚)(P<0.05).<12枚、≥12枚淋巴結兩組在Ⅰ期或Ⅳ期的結直腸癌5年生存率無明顯差彆(89.5%vs.89.1%,8.0%vs.18.2%,P>0.05),而≥12枚淋巴結的Ⅱ期和Ⅲ期5年生存率明顯高于<12枚(71.1%vs.32.6%,48.8%vs.30.0%,P<0.05),多因素COX迴歸模型分析錶明,病檢淋巴結數目是Ⅱ、Ⅲ期結直腸癌獨立的預後因素.結論 病檢的淋巴結數目主要通過影響Ⅱ、Ⅲ期的預後與結直腸癌總5年生存率明顯相關,是Ⅱ、Ⅲ期結直腸癌獨立的預後因素.
목적 탐토병검림파결수목여결직장암분기급예후적관계.방법 장567례결직장암환자근거술후병검적림파결수목분위3개조:≤6매、7～11매、≥12매조,비교각조5년생존솔적차별.TNM분기(Ⅰ～Ⅳ기)분별이병검림파결수목분위<12매화≥12매량조,비교각분기중량조적5년생존솔적차별,분석예후상관인소.5년생존솔적비교채용Kaplan-Meier법병경Log-rank검험,예후다인소분석채용Cox비례풍험모형.결과 567례평균병검림파결수목위(16.75±9.88)매,병검림파결수목분별위≤6매,7～11매,≥12매시,결직장암5년생존솔각위32.3%(21/65),43.8%(53/121),57.7%(220/381),단인소분석표명,병검림파결수목≥12매적결직장암5년생존솔명현고우기타량조(≤6매,7～11매)(P<0.05).<12매、≥12매림파결량조재Ⅰ기혹Ⅳ기적결직장암5년생존솔무명현차별(89.5%vs.89.1%,8.0%vs.18.2%,P>0.05),이≥12매림파결적Ⅱ기화Ⅲ기5년생존솔명현고우<12매(71.1%vs.32.6%,48.8%vs.30.0%,P<0.05),다인소COX회귀모형분석표명,병검림파결수목시Ⅱ、Ⅲ기결직장암독립적예후인소.결론 병검적림파결수목주요통과영향Ⅱ、Ⅲ기적예후여결직장암총5년생존솔명현상관,시Ⅱ、Ⅲ기결직장암독립적예후인소.
Objective To study the relationship between the number of examined lymph nodes and the prognosis of colorectal cancer by TNM stage. Methods According to the number of examined lymph nodes, 567 patients of colorectal carcinoma who underwent resection were divided into three groups: ≤ 6,7-11 and ≥ 12, the 5-year overall survival rates of three groups were compared. For each TNM stage ( stage Ⅰ -Ⅳ ) , patients were substratified into two groups basing on the number of examined lymph nodes:<12 group and ≥12 group, the 5-year survival rates of two groups in each TNM stage were assessed, and prognostic factors of stage Ⅱ and Ⅲ stage were analyzed. 5-year survival curves were estimated with the Kaplan-Meier method and compared by the log-rank test. Cox proportional models were used to conduct multivariate analyses of prognostic factors. Results The average number of examined lymph nodes was 16. 75 ±9. 88. With the patients grouped by the number of lymph nodes ( ≤6,7 -11 and ≥12 nodes) , the 5-year survival rate was 32. 3% , 43. 8% , and 57. 7% , the univariable analysis indicated that the 5-year survival rate of ≥ 12 examined nodes were significantly higher than the other groups (P<0. 05). There was no difference between two groups in the 5-year survival rates of stage Ⅰ or Ⅳ colorectal cancer (89. 5% vs.89. 1% ,8. 0% vs. 18. 2% , P>0. 05 ) , however, the 5-year survival rates of stage Ⅱ and Ⅲ colorectal cancer in ≥12 group were significantly higher than<12 group(71. 1% vs. 32. 6% ,48. 8% vs. 30. 0% ,P<0. 05) , multivariable analysis revealed that the number of lymph nodes examined was an independent factor of prognosis of stage Ⅱ and Ⅲ colorectal cancer. Conclusions The number of examined lymph nodes significantly influenced the 5-year overall survival rate of TNM stage Ⅱ and Ⅲ colorectal cancer.
