左右半结肠癌根治性切除术患者的临床病理特征及预后对比
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刘防震,E-mail:liufangzhen01@163.com

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Comparison of clinicopathologic features and prognosis between right-sided and left-sided colectomy
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    摘要:

    目的 比较左、右半结肠癌根治性切除术患者的临床病理特征和预后。方法 分析2010年1月— 2013年12月哈励逊国际和平医院行根治性手术的196例结肠癌患者临床病理资料,根据肿瘤位置分为右半结肠癌组(104例)和左半结肠癌组(92例),比较两组临床病理特征及预后是否存在差异。采用Kaplan-Meier法绘制生存曲线,比较用Log-rank χ2检验,多因素分析采用Cox回归模型。结果 右半结肠癌组患者年龄偏大、低分化或黏液腺癌比例高、淋巴结检出数目高。临床首发症状中,右半结肠癌组贫血或体重下降比例高,而左半结肠癌组中便血或排便习惯改变比例高。全组中位随访时间为69个月。右半结肠癌组与左半结肠癌组的5年无病生存率(DFS)分别为53.8%和70.5%(P?>0.05),5年总生存率(OS)分别为65.4%和77.2%(P?< 0.05)。pTNM Ⅱ期中,右半结肠癌组与左半结肠癌组的5年DFS分别为62.7%和70.0%(P?>0.05),5年OS分别为74.6%和78.0%(P?>0.05);pTNM Ⅲ期中,右半结肠癌组与左半结肠癌组的5年DFS分别为36.6%和65.1%(P?<0.05),5年OS分别为48.8%和71.4%(P?<0.05)。多因素分析显示,pTNM分期[HlR=3.07(95% CI:1.95,4.85)]和pT分期[HlR=1.83(95% CI:1.38,2.43)]是影响结肠癌术后DFS的独立危险因素,pT分期[HlR= 1.91(95% CI:1.41,2.61)]及pN分期[HlR=2.21(95% CI:1.62,3.00)]是影响结肠癌术后OS的独立危险因素,而肿瘤位置不是影响结肠癌预后的危险因素。结论 左右半结肠癌临床病理特征存在差异。右半结肠癌整体预后较左半结肠癌差,在Ⅲ期患者中更明显。

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    Objective To compare the clinicopathologic features and prognosis of patients between right-sided colon cancer (RCC) and left-sided colon cancer (LCC) after radical resection. Methods A retrospective analysis of clinical data was made among cases of colon cancer undergoing radical surgeries at Harrsion International Peace Hospital from January 2010 to December 2013. The patients were divided into RCC group (n?=?104) and LCC group (n?=?92). The differences of clinicopathologic features and prognosis of patients in different group were compared. Overall survival (OS) and disease-free survival (DFS) were analyzed with the Kaplan–Meier method, and the difference test was carried out with Log-rank test. Univariate and multivariate analyses were performed with Cox regression model. Results Data of RCC exhibited older ages, higher incidence of poor differentiation or mucinous adenocarcinoma, more harvested lymph nodes than LCC. Weight loss and anemia occupied a high proportion in the first symptoms for the patients with RCC, as hematochezia and changes in bowel habits presented in patients with LCC. Median follow-up time was 69 months. The 5-year disease-free survival (DFS) rates for patients with RCC and LCC were 53.8% and 70.5% (P?>?0.05), while the 5-year overall survival (OS) rates were 65.4% and77.2% (P??0.05), while the 5-OS rates were 74.6% and 78.0% (P?>?0.05); in stage III cancers, the 5-DFS rates for patients with RCC and LCC were 36.6% and 65.1% (P?< 0.05), while the 5-OS rates were 48.8% and 71.4% (P?

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郭振江,王宁,刘防震.左右半结肠癌根治性切除术患者的临床病理特征及预后对比[J].中国现代医学杂志,2020,(21):67-73

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  • 收稿日期:2020-04-30
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  • 在线发布日期: 2020-11-15
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