中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2012年
12期
826-829
,共4页
王铭河%徐烨%盛伟琪%蔡三军
王銘河%徐燁%盛偉琪%蔡三軍
왕명하%서엽%성위기%채삼군
直肠肿瘤%神经内分泌肿瘤%淋巴转移%预后
直腸腫瘤%神經內分泌腫瘤%淋巴轉移%預後
직장종류%신경내분비종류%림파전이%예후
Rectal neoplasms%Neuroendocrine tumors%Lymphatic metastasis%Prognosis
目的 研究直肠神经内分泌肿瘤(NET)的临床病理因素与淋巴结转移及预后的关系,探讨手术方式的选择.方法 收集48例直肠NET切除术后患者的临床病理资料.分别采用卡方检验和Logistic回归法进行肿瘤临床病理因素与淋巴结转移关系的单因素和多因素分析.采用Kaplan-Meier方法进行预后单因素生存分析,以Log-rank检验进行生存率比较,采用Cox模型进行预后多因素生存分析.结果 单因素分析显示,与淋巴结转移相关的临床病理因素为肿瘤距肛缘≤6 cm、肿瘤最大径＞2 cm、有肌层浸润、有远处转移、组织学3级.多因素分析显示,组织学3级是淋巴结转移的独立相关因素[比值比(OR)=9.333,95％可信区间(CD:1.054～82.635,P=0.045].单因素生存分析显示,预后差的相关因素为肿瘤距肛缘≤6 cm、肿瘤最大径＞2 cm、有肌层浸润、有淋巴结转移、有远处转移、组织学3级.多因素生存分析显示,肿瘤距肛缘≤6 cm[风险比(HR)=0.215,95％CI:0.047～0.980,P=0.047]、有远处转移(HR=8.788,95％CI:2.612～29.571,P＜0.01)、组织学3级(HR=5.510,95％CI:1.692～17.944,P=0.005)是预后差的独立相关因素.结论 在无远处转移的情况下,对于组织学1级和2级的直肠NET患者,若肿瘤最大径＞2 cm或有肌层浸润,推荐其接受根治性手术;在无远处转移的情况下,组织学3级的直肠NET患者均推荐其接受根治性手术.
目的 研究直腸神經內分泌腫瘤(NET)的臨床病理因素與淋巴結轉移及預後的關繫,探討手術方式的選擇.方法 收集48例直腸NET切除術後患者的臨床病理資料.分彆採用卡方檢驗和Logistic迴歸法進行腫瘤臨床病理因素與淋巴結轉移關繫的單因素和多因素分析.採用Kaplan-Meier方法進行預後單因素生存分析,以Log-rank檢驗進行生存率比較,採用Cox模型進行預後多因素生存分析.結果 單因素分析顯示,與淋巴結轉移相關的臨床病理因素為腫瘤距肛緣≤6 cm、腫瘤最大徑＞2 cm、有肌層浸潤、有遠處轉移、組織學3級.多因素分析顯示,組織學3級是淋巴結轉移的獨立相關因素[比值比(OR)=9.333,95％可信區間(CD:1.054～82.635,P=0.045].單因素生存分析顯示,預後差的相關因素為腫瘤距肛緣≤6 cm、腫瘤最大徑＞2 cm、有肌層浸潤、有淋巴結轉移、有遠處轉移、組織學3級.多因素生存分析顯示,腫瘤距肛緣≤6 cm[風險比(HR)=0.215,95％CI:0.047～0.980,P=0.047]、有遠處轉移(HR=8.788,95％CI:2.612～29.571,P＜0.01)、組織學3級(HR=5.510,95％CI:1.692～17.944,P=0.005)是預後差的獨立相關因素.結論 在無遠處轉移的情況下,對于組織學1級和2級的直腸NET患者,若腫瘤最大徑＞2 cm或有肌層浸潤,推薦其接受根治性手術;在無遠處轉移的情況下,組織學3級的直腸NET患者均推薦其接受根治性手術.
목적 연구직장신경내분비종류(NET)적림상병리인소여림파결전이급예후적관계,탐토수술방식적선택.방법 수집48례직장NET절제술후환자적림상병리자료.분별채용잡방검험화Logistic회귀법진행종류림상병리인소여림파결전이관계적단인소화다인소분석.채용Kaplan-Meier방법진행예후단인소생존분석,이Log-rank검험진행생존솔비교,채용Cox모형진행예후다인소생존분석.결과 단인소분석현시,여림파결전이상관적림상병리인소위종류거항연≤6 cm、종류최대경＞2 cm、유기층침윤、유원처전이、조직학3급.다인소분석현시,조직학3급시림파결전이적독립상관인소[비치비(OR)=9.333,95％가신구간(CD:1.054～82.635,P=0.045].단인소생존분석현시,예후차적상관인소위종류거항연≤6 cm、종류최대경＞2 cm、유기층침윤、유림파결전이、유원처전이、조직학3급.다인소생존분석현시,종류거항연≤6 cm[풍험비(HR)=0.215,95％CI:0.047～0.980,P=0.047]、유원처전이(HR=8.788,95％CI:2.612～29.571,P＜0.01)、조직학3급(HR=5.510,95％CI:1.692～17.944,P=0.005)시예후차적독립상관인소.결론 재무원처전이적정황하,대우조직학1급화2급적직장NET환자,약종류최대경＞2 cm혹유기층침윤,추천기접수근치성수술;재무원처전이적정황하,조직학3급적직장NET환자균추천기접수근치성수술.
Objective To study the correlation between clinicopathological characteristics and lymph node metastasis and prognosis of rectal neuroendocrine tumors (NET),and try to explore the choice of surgical approach.Methods The clinicopathological data of 48 postoperative rectal NET patients were collected.The univariate and multivariate analysis of the correlation between clinicopathologic characteristics and lymph node metastasis were performed by chi-square test and Logistic regression.The prognosis single factor survival analysis was analyzed by Kaplan-Meier method.The survival rates were compared by Log-rank test.The prognosis multivariate survival analysis was performed by the use of Cox model.Results The results of univariate analysis indicated that clinicopathological characteristics related with lymph node metastasis were tumor distance from anal verge less than six cm,tumor diameter over two cm,muscularis invasion,distant metastasis and histological grade 3.The results of multivariate analysis showed that histological grade 3 was an independent risk factor of lymph node metastasis (OR=9.333,95 ％CI:1.054 to 82.635,P=0.045).The results of univariate survival analysis suggested that factors correlated with poor prognosis were tumor distance from anal verge less than six cm,tumor diameter over two cm,muscularis invasion,lymph node metastasis,distant metastasis and histological grade 3.The results of multivariate survival analysis indicated that tumor distance from anal verge less than six cm (HR=0.215,95 ％CI:0.047 to 0.980,P=0.047),distant metastasis (HR=8.788,95％CI:2.612 to 29.571,P＜0.01) and histological grade3 (HR=5.510,95％CI:1.692-17.944,P=0.005) were independent factors associated with poor prognosis.Conclusions For histological grade 1 and 2 rectal NET patients without distant metastasis,radical surgery is recommended when tumor diameter over two cm or muscularis invasion exists.For histological grade 3 rectal NET patients without distant metastasis,radical surgery is recommended.
