中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
12期
974-977
,共4页
孙国瑞%徐阳%曲辉%周鹏%彭景伟%何庆泗
孫國瑞%徐暘%麯輝%週鵬%彭景偉%何慶泗
손국서%서양%곡휘%주붕%팽경위%하경사
直肠肿瘤%淋巴结切除术%预后
直腸腫瘤%淋巴結切除術%預後
직장종류%림파결절제술%예후
Rectal neoplasm%Lymph nodes excision%Prognosis
目的 探讨Ⅲ期直肠癌根治术后淋巴结清扫总数及阴性淋巴结数与预后的关系.方法 回顾性分析山东大学齐鲁医院2002—2007年412例Ⅲ期直肠癌根治术患者的临床资料.依淋巴结清扫总数及阴性淋巴结数分为5组,分别为1～6枚组、7～12枚组、13～18枚组、19～24枚组和＞ 24枚组,用Kaplan-Meier法计算生存率,生存率的组间比较采用Log-rank检验并做趋势检验.应用Pearson相关分析法分析淋巴结清扫总数与阴性淋巴结数的相关性.多因素分析采用Cox比例风险模型分析.结果 患者1、3、5年生存率分别为79.9％,59.2％,43.0％.患者术后5年生存率随淋巴结清扫总数及阴性淋巴结数目的增加而升高(20.0％、26.5％、43.9％、54.2％、53.5％,P=0.001；10.3％、34.8％、51.9％、56.8％、70.8％,P=0.000).412例患者共清扫淋巴结7301枚,阴性淋巴结5698枚,淋巴结清扫总数及阴性淋巴结数具有明显相关性(r =0.899,P=0.000).淋巴结清扫总数及阴性淋巴结数为独立预后因素.结论 在Ⅲ期直肠癌根治术中,淋巴结清扫总数及阴性淋巴结数与预后明显相关,在规范化进行根治性手术的前提下,可将淋巴结清扫总数及阴性淋巴结数作为判断预后的辅助指标.
目的 探討Ⅲ期直腸癌根治術後淋巴結清掃總數及陰性淋巴結數與預後的關繫.方法 迴顧性分析山東大學齊魯醫院2002—2007年412例Ⅲ期直腸癌根治術患者的臨床資料.依淋巴結清掃總數及陰性淋巴結數分為5組,分彆為1～6枚組、7～12枚組、13～18枚組、19～24枚組和＞ 24枚組,用Kaplan-Meier法計算生存率,生存率的組間比較採用Log-rank檢驗併做趨勢檢驗.應用Pearson相關分析法分析淋巴結清掃總數與陰性淋巴結數的相關性.多因素分析採用Cox比例風險模型分析.結果 患者1、3、5年生存率分彆為79.9％,59.2％,43.0％.患者術後5年生存率隨淋巴結清掃總數及陰性淋巴結數目的增加而升高(20.0％、26.5％、43.9％、54.2％、53.5％,P=0.001；10.3％、34.8％、51.9％、56.8％、70.8％,P=0.000).412例患者共清掃淋巴結7301枚,陰性淋巴結5698枚,淋巴結清掃總數及陰性淋巴結數具有明顯相關性(r =0.899,P=0.000).淋巴結清掃總數及陰性淋巴結數為獨立預後因素.結論 在Ⅲ期直腸癌根治術中,淋巴結清掃總數及陰性淋巴結數與預後明顯相關,在規範化進行根治性手術的前提下,可將淋巴結清掃總數及陰性淋巴結數作為判斷預後的輔助指標.
목적 탐토Ⅲ기직장암근치술후림파결청소총수급음성림파결수여예후적관계.방법 회고성분석산동대학제로의원2002—2007년412례Ⅲ기직장암근치술환자적림상자료.의림파결청소총수급음성림파결수분위5조,분별위1～6매조、7～12매조、13～18매조、19～24매조화＞ 24매조,용Kaplan-Meier법계산생존솔,생존솔적조간비교채용Log-rank검험병주추세검험.응용Pearson상관분석법분석림파결청소총수여음성림파결수적상관성.다인소분석채용Cox비례풍험모형분석.결과 환자1、3、5년생존솔분별위79.9％,59.2％,43.0％.환자술후5년생존솔수림파결청소총수급음성림파결수목적증가이승고(20.0％、26.5％、43.9％、54.2％、53.5％,P=0.001；10.3％、34.8％、51.9％、56.8％、70.8％,P=0.000).412례환자공청소림파결7301매,음성림파결5698매,림파결청소총수급음성림파결수구유명현상관성(r =0.899,P=0.000).림파결청소총수급음성림파결수위독립예후인소.결론 재Ⅲ기직장암근치술중,림파결청소총수급음성림파결수여예후명현상관,재규범화진행근치성수술적전제하,가장림파결청소총수급음성림파결수작위판단예후적보조지표.
Objective To study retrospectively the relation of the number of all dissected and negative lymph nodes (LNs) to the prognosis of patients with stage Ⅲ rectal carcinoma after radical resection.Methods From 2002 to 2007,412 sage Ⅲ rectal carcinoma patients undergoing radical resection were enrolled.Patients were divided into five groups according to the number of dissected LNs as follows:1 to 6 lymph nodes,7 to 12 lymph nodes,13 to 18 lymph nodes,19 to 24 lymph nodes,and more than 24 lymph nodes.The association with the survival was analyzed.The Kaplan-Meier method was used to estimate survival as a function of time,and survival differences were analyzed with the log-rank test.The correlation between all dissected and negative lymph nodes was analyzed.The Cox proportional hazard model were used to investigate the risk factors for stage Ⅲ rectal carcinoma.Results The 1,3 and 5 years survival rates were respectively 79.9％,59.2％ and 43.0％.The 5-year survival rates increased with the increasing number of the examined LNs and the negative LNs,the differences were significant (20.0％、26.5％ 、43.9％ 、54.2％ 、53.5％,P =0.001 ; 10.3％ 、34.8％ 、51.9％ 、56.8％ 、70.8％,P =0.000).There were 7301 LNs dissected among which 5698 were pathology negative.The dissected LNs were correlated positively with negative LNs on the Pearson's correlation test(correlation coefficients r =0.899).The total number of dissected LNs and negative LNs were independent prognostic predictors.Conclusions The total number of dissected lymph node and negative lymph nodes are significantly correlated to prognosis of staged Ⅲ rectal carcinoma patient.On premise of standard procedure,we see all dissected and negative lymph nodes as a prognostic auxiliary index.
