中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2009年
20期
13-16
,共4页
赖金火%周永建%卢辉山%张祥福%郑知文%吴心愿%王川%黄昌明%官国先
賴金火%週永建%盧輝山%張祥福%鄭知文%吳心願%王川%黃昌明%官國先
뢰금화%주영건%로휘산%장상복%정지문%오심원%왕천%황창명%관국선
直肠肿瘤%肝肿瘤,继发性%青年患者%回归分析
直腸腫瘤%肝腫瘤,繼髮性%青年患者%迴歸分析
직장종류%간종류,계발성%청년환자%회귀분석
Rectal carcinoma%Liver neoplasms,secondary%Young patients%Logistic regression
目的 探讨青年人直肠癌肝转移的相关因素,以期降低肝转移率,延长生存时间.方法 选择青年人直肠癌患者350例,对其病理组织类型、血管侵袭、TNM分期等临床因素用Logistic回归进行单因素和多因素分析.并对有意义的指标进行相关分析,建立肝转移危险因素的回归方程.结果 120例出现肝转移,转移率为34.3%.单因素分析显示:直肠癌肝转移的相关因素主要有病理组织类型、病理大体类型、肠壁内浸润范围、血管侵袭、TNM分期、手术性质、术前血清癌胚抗原(CEA)水平、组织学分级.而性别、肿瘤部位、PCNA增殖指数、手术方式则与肝转移无关.多因素分析显示:仅血管侵袭(P=0.001)、TNM分期(P=0.001)、病理组织类型(P=0.005)、术前血清CEA水平(P=0.008)、手术性质(P=0.032)是影响肝转移的独立因素.结论 青年人直肠癌患者病理组织类型为高度恶性潜能、术前血清CEA水平高表达、进展期、有血管侵袭者和手术性质为非R0者,易发生肝转移,术后应予严密随访、个体化辅助治疗.
目的 探討青年人直腸癌肝轉移的相關因素,以期降低肝轉移率,延長生存時間.方法 選擇青年人直腸癌患者350例,對其病理組織類型、血管侵襲、TNM分期等臨床因素用Logistic迴歸進行單因素和多因素分析.併對有意義的指標進行相關分析,建立肝轉移危險因素的迴歸方程.結果 120例齣現肝轉移,轉移率為34.3%.單因素分析顯示:直腸癌肝轉移的相關因素主要有病理組織類型、病理大體類型、腸壁內浸潤範圍、血管侵襲、TNM分期、手術性質、術前血清癌胚抗原(CEA)水平、組織學分級.而性彆、腫瘤部位、PCNA增殖指數、手術方式則與肝轉移無關.多因素分析顯示:僅血管侵襲(P=0.001)、TNM分期(P=0.001)、病理組織類型(P=0.005)、術前血清CEA水平(P=0.008)、手術性質(P=0.032)是影響肝轉移的獨立因素.結論 青年人直腸癌患者病理組織類型為高度噁性潛能、術前血清CEA水平高錶達、進展期、有血管侵襲者和手術性質為非R0者,易髮生肝轉移,術後應予嚴密隨訪、箇體化輔助治療.
목적 탐토청년인직장암간전이적상관인소,이기강저간전이솔,연장생존시간.방법 선택청년인직장암환자350례,대기병리조직류형、혈관침습、TNM분기등림상인소용Logistic회귀진행단인소화다인소분석.병대유의의적지표진행상관분석,건립간전이위험인소적회귀방정.결과 120례출현간전이,전이솔위34.3%.단인소분석현시:직장암간전이적상관인소주요유병리조직류형、병리대체류형、장벽내침윤범위、혈관침습、TNM분기、수술성질、술전혈청암배항원(CEA)수평、조직학분급.이성별、종류부위、PCNA증식지수、수술방식칙여간전이무관.다인소분석현시:부혈관침습(P=0.001)、TNM분기(P=0.001)、병리조직류형(P=0.005)、술전혈청CEA수평(P=0.008)、수술성질(P=0.032)시영향간전이적독립인소.결론 청년인직장암환자병리조직류형위고도악성잠능、술전혈청CEA수평고표체、진전기、유혈관침습자화수술성질위비R0자,역발생간전이,술후응여엄밀수방、개체화보조치료.
Objective To detect the clinical factors related with liver metastasis in young patients with rectal cancer.Methods Three hundred and fifty young patients with rectal cancer were collected to set up the database.Single and multi-factor Logistic regression was applied to indicate the independent factors relating to liver metastasis.The regression equation to predict probability of liver metastasis from rectal cancer was established.Results Liver metastasis was 120 cases (34.3%).Single-factor analysis revealed that patho-organization type,pathologytype,infiltration extent,blood vessel invasion (BVI),TNM stage,operation character,the preoperative level of carcino-embryonic antigen,histology grading were related with liver metastasis.Multi-factor analysis revealed that only BVI (P=0.001),TNM stage (P=0.001),pathoorganization type (P=0.005),the preoperative level of CEA (P=0.008) and operation character (P=0.032) were independent factors to predict probability of liver metastasis.Conclusions Rectal cancer of young patients who being with BVI,advanced phase,high preoperative level of CEA,radical operation or poor differentiation degree,are apt to develop liver metastasis.They should be given further individualized intensive adjuvant treatment.
