中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
7期
673-675
,共3页
杨涵%潘贻飞%高尔立%张筱骅
楊涵%潘貽飛%高爾立%張篠驊
양함%반이비%고이립%장소화
直肠癌%淋巴结转移%临床规律%探析
直腸癌%淋巴結轉移%臨床規律%探析
직장암%림파결전이%림상규률%탐석
Colorectal cancer%Lymph node metastasis%Clinical law%Analysis
目的 探讨直肠癌淋巴结转移的临床规律,为直肠癌的临床诊治提供参考.方法 对我院2006年11月至2012年1月收治的222例行手术治疗的直肠癌患者资料进行分类整理,对各因素与淋巴结转移的相关性进行归纳分析,并进行Logistic回归分析.结果 (1)性别与淋巴结转移率没有明显的相关性(x2 =0.000,P＞0.05).(2)淋巴结的转移率随着年龄的增大而降低且差异有统计学意义(x2 =5.001,P＜0.05).(3)肿瘤所在部位与淋巴结转移率差异无统计学意义(x2 =0.052,P＞0.05),但有直肠癌距肛门越近淋巴结转移率越高的趋势,其大小与淋巴结转移率具有明显的相关性,2.5～5.5 cm组和≥5.5 cm组淋巴结转移率明显高于≤2.5 cm组且差异有统计学意义(x2=2.267,P＜0.05).(4)肿瘤侵犯肠管周径与淋巴结转移率密切相关(x2=2.323,P＜0.05).(5)淋巴结的转移率与浸润深度有密切关系,转移率随着浸润深度的增加而升高(x2=2.277,P＜0.05).(6)随着肿瘤分化程度的降低淋巴结的转移率显著升高(x2=4.322,P＜0.01).(7)Logistic回归分析表明,肿瘤分化程度、浸润程度及侵犯肠管周径对淋巴结转移有影响,OR(95％ CI)分别为5.562(0.105～0.444)、2.178(0.144 ～0.971)、1.563(0.038 ～8.613)(P均＜0.01).结论 直肠癌淋巴结转移与患者的年龄、肿瘤的大小、侵犯肠管的周径、浸润的深度以及分化的程度具有密切的相关性,其中肿瘤的分化程度对淋巴结转移的影响最为显著.
目的 探討直腸癌淋巴結轉移的臨床規律,為直腸癌的臨床診治提供參攷.方法 對我院2006年11月至2012年1月收治的222例行手術治療的直腸癌患者資料進行分類整理,對各因素與淋巴結轉移的相關性進行歸納分析,併進行Logistic迴歸分析.結果 (1)性彆與淋巴結轉移率沒有明顯的相關性(x2 =0.000,P＞0.05).(2)淋巴結的轉移率隨著年齡的增大而降低且差異有統計學意義(x2 =5.001,P＜0.05).(3)腫瘤所在部位與淋巴結轉移率差異無統計學意義(x2 =0.052,P＞0.05),但有直腸癌距肛門越近淋巴結轉移率越高的趨勢,其大小與淋巴結轉移率具有明顯的相關性,2.5～5.5 cm組和≥5.5 cm組淋巴結轉移率明顯高于≤2.5 cm組且差異有統計學意義(x2=2.267,P＜0.05).(4)腫瘤侵犯腸管週徑與淋巴結轉移率密切相關(x2=2.323,P＜0.05).(5)淋巴結的轉移率與浸潤深度有密切關繫,轉移率隨著浸潤深度的增加而升高(x2=2.277,P＜0.05).(6)隨著腫瘤分化程度的降低淋巴結的轉移率顯著升高(x2=4.322,P＜0.01).(7)Logistic迴歸分析錶明,腫瘤分化程度、浸潤程度及侵犯腸管週徑對淋巴結轉移有影響,OR(95％ CI)分彆為5.562(0.105～0.444)、2.178(0.144 ～0.971)、1.563(0.038 ～8.613)(P均＜0.01).結論 直腸癌淋巴結轉移與患者的年齡、腫瘤的大小、侵犯腸管的週徑、浸潤的深度以及分化的程度具有密切的相關性,其中腫瘤的分化程度對淋巴結轉移的影響最為顯著.
목적 탐토직장암림파결전이적림상규률,위직장암적림상진치제공삼고.방법 대아원2006년11월지2012년1월수치적222례행수술치료적직장암환자자료진행분류정리,대각인소여림파결전이적상관성진행귀납분석,병진행Logistic회귀분석.결과 (1)성별여림파결전이솔몰유명현적상관성(x2 =0.000,P＞0.05).(2)림파결적전이솔수착년령적증대이강저차차이유통계학의의(x2 =5.001,P＜0.05).(3)종류소재부위여림파결전이솔차이무통계학의의(x2 =0.052,P＞0.05),단유직장암거항문월근림파결전이솔월고적추세,기대소여림파결전이솔구유명현적상관성,2.5～5.5 cm조화≥5.5 cm조림파결전이솔명현고우≤2.5 cm조차차이유통계학의의(x2=2.267,P＜0.05).(4)종류침범장관주경여림파결전이솔밀절상관(x2=2.323,P＜0.05).(5)림파결적전이솔여침윤심도유밀절관계,전이솔수착침윤심도적증가이승고(x2=2.277,P＜0.05).(6)수착종류분화정도적강저림파결적전이솔현저승고(x2=4.322,P＜0.01).(7)Logistic회귀분석표명,종류분화정도、침윤정도급침범장관주경대림파결전이유영향,OR(95％ CI)분별위5.562(0.105～0.444)、2.178(0.144 ～0.971)、1.563(0.038 ～8.613)(P균＜0.01).결론 직장암림파결전이여환자적년령、종류적대소、침범장관적주경、침윤적심도이급분화적정도구유밀절적상관성,기중종류적분화정도대림파결전이적영향최위현저.
Objective To investigate the regulations of lymphatic metastasis of rectal carcinoma which can provide help of clinical diagnosis and treatments.Methods A retrospective analysis was performed of 222 patients with rectal carcinoma who underwent surgical resection from November 2006 to January 2012.Summarize the relevance of each factor and lymph node metastasis by logistic regression analysis.Results (1) Gender and lymph node metastasis has no significant correlation (x2 =0.000,P ＞ 0.05).(2) Lymph node metastasis rate reduced with increasing age and the difference was statistically significant (x2 =5.001,P ＜ 0.05).(3) There is no significant difference between tumor location and lymph node metastasis rate (x2 =0.052,P ＞ 0.05),when the distance between anal rectal cancer and the anus was closer,the tendency of lymph node metastasis was higher,and there has the obvious correlation with lymph node metastasis rate of its size,2.5 to 5.5 cm group and more than 5.5 cm lymph node metastasis rate was significantly higher than less than 2.5 cm group with a significant difference (x2 =2.267,P ＜ 0.05).(4) Tumor invasion of the intestinal circumference was closely related with lymph node metastasis rate (x2 =2.323,P ＜0.01).(5) Lymph node metastasis rate was closely related to the depth of invasion,metastasis rate increased with the depth of invasion increasing(x2 =2.277,P ＜0.05).(6) Lymph node metastasis was significantly higher with the decrease of the degree of tumor differentiation (x2 =4.322,P ＜ 0.01).Logistic regression analysis showed that the degree of tumor differentiation,infiltration and invasion of intestinal circumference diameter lymph node metastasis influential,OR (95 ％ CI) was 5.562 (0.105-0.444),2.178 (0.144-0.971),1.563 (0.038-8.613) respectively (P ＜0.01).Conclusion The lymphatic metastasis of rectal carcinoma is related to age,tumor size,intestinal circumference invasion,depth of tumor invasion and the differentiating degree of the tumor,and the differentiating degree is the major factor.
