CAJ | 학술논문

目的：收集并分析2002年1月-2013年6月11年间209例行结肠癌根治术的老年患者的病理特征和手术情况，探讨影响术后复发转移的因素。方法采用Cox风险比例模型对患者的年龄、性别、病程、住院时长、手术医生经验、手术时长、是否为腹腔镜手术、肿瘤部位、肿瘤大小、肿瘤大体形态、分化程度、浸润深度、淋巴结转移和梗阻共计14个变量进行单因素和多因素分析，运用Kaplan-Meier法绘制患者术后复发转移生存曲线。结果单因素分析发现，肿瘤大小（ RR＝2．658， P＜0．0001）、大体形态（浸润型RR＝3．407，P＝0．0054）、分化程度（RR＝0．32，P＜0．0001）与结肠癌根治术后复发转移有关，多因素分析结果显示，患者性别（RR＝0．585，P＝0．0359）、肿瘤大小（RR＝2．364，P＜0．0001）、大体形态（浸润型RR＝0．246，P＝0．0437）、分化程度（RR＝0．31，P＜0．0001）与结肠癌根治术后复发转移有关。结论患者性别、肿瘤大小、大体形态和分化程度是影响老年结肠癌根治术后复发转移的因素，对确定高危人群，进行有针对性的术后随访，提早发现和治疗有重要意义，有利于提高患者生活质量，延长患者生存时间。
목적：수집병분석2002년1월-2013년6월11년간209례행결장암근치술적노년환자적병리특정화수술정황，탐토영향술후복발전이적인소。방법채용Cox풍험비례모형대환자적년령、성별、병정、주원시장、수술의생경험、수술시장、시부위복강경수술、종류부위、종류대소、종류대체형태、분화정도、침윤심도、림파결전이화경조공계14개변량진행단인소화다인소분석，운용Kaplan-Meier법회제환자술후복발전이생존곡선。결과단인소분석발현，종류대소（ RR＝2．658， P＜0．0001）、대체형태（침윤형RR＝3．407，P＝0．0054）、분화정도（RR＝0．32，P＜0．0001）여결장암근치술후복발전이유관，다인소분석결과현시，환자성별（RR＝0．585，P＝0．0359）、종류대소（RR＝2．364，P＜0．0001）、대체형태（침윤형RR＝0．246，P＝0．0437）、분화정도（RR＝0．31，P＜0．0001）여결장암근치술후복발전이유관。결론환자성별、종류대소、대체형태화분화정도시영향노년결장암근치술후복발전이적인소，대학정고위인군，진행유침대성적술후수방，제조발현화치료유중요의의，유리우제고환자생활질량，연장환자생존시간。
Objective To analyze the clinicopathologic data and operative parameters of 209 elderly co-lon cancer patients treated by radical resection between January 2002 and December 2011 ,and to investigate the factors related to recurrence and metastasis after colon cancer radical resection in elderly patients .Methods We used univariate and multivariate analysis of Cox regression ,including 14 variables:age,gender,disease duration, hospitalization duration,surgeon experience,operation duration,laparoscopicsurgery,tumor location,tumor size, gross morphology ,differentiate degree ,depth of bowel wall invasion ,lymph node involvement and obstruction .The survival curve was obtained by Kaplan -Meier method.Results Univariate analysis showed that tumor size (RR=2.658,P<0.0001),gross morphology(Infiltrating type,RR=3.407,P=0.0054),degree of differentiation (RR=0.32,P<0.0001) were associated with tumor relapse and metastasis .Multivariate analysis showed that gender(RR=0.585,P=0.0359),tumor size(RR=2.364,P<0.0001),degree of differentiation (Infiltrating type,RR=0.246,P=0.0437),gross morphology(RR=0.31,P<0.0001)were the significant factors.Conclu-sion Gender,tumor size,degree of differentiation,gross morphology were the independent factors of recurrence and metastasis of colon cancer after radical resection in elderly patients .Targeted follow -up for high -risk groups will improve patients′life quality and prolong their survival time .