摘要
目的探讨中低位直肠癌环周切缘的影响因素,并评估环周切缘与预后之间的关系。方法回顾性分析我院2004年1月～2006年1月47例中低位直肠癌患者病理及临床资料。所有患者均采用TME原则行直肠癌根治术,比较环周切缘与中低位直肠癌患者局部复发、远隔转移、临床及病理特点之间的关系。采用Kaplan-Meier曲线及Long-rank检验分析环周切缘与中低位直肠患者生存率之间的相关性。结果至2009年3月,已有17例死亡,其中环周切缘阳性7例,环周切缘阴性10例;其中出现局部复发有5例,远隔转移12例。病理检查:环周切缘阳性12例,其中4例出现局部复发,5例出现远隔转移,环周切缘阴性35例,其中1例出现局部复发,7例出现远隔转移。Kaplan-Meier生存曲线显示环周切缘阴性患者生存率明显高于环周切缘阳性患者;环周切缘与癌肿浸润深度、癌肿大小、癌肿环周度之间有显著性差异(P<0.05)。结论环周切缘与直肠癌浸润深度、癌肿大小、癌肿环周度密切相关,可作为中低位直肠癌局部复发及远隔转移、存活率的预测指标之一,可作为危险因素之一、为选择性放化疗提供依据。
Objective To analyze influencing factors of circumferential resection margin（CRM） and to assess the relationship between CRM status and prognosis.Methods The pathological and clinical datas of 47 patients with middle and low rectal carcinoma who received total mesorectal excision in our department from January 2004 to January 2006,were analyzed retrospectively.The relationships between CRM and local recurrence,distant recurrence,clinicopathologic characteristics were evaluated.The relationship between CRM and the survival rate were analyzed by Kaplan-Meier and Long-rank.Results 17 of the 47 patients died, which included 7 CRM-positive （CRM ＋） patients and 10 CRM-negative （CRM -） patients;5 patients had local recurrence in which 4 cases were CRM ＋ and one case was CRM -.12 patients developed distant recurrence in which 5 cases were CRM ＋ and 7 cases were CRM-.Kaplan-Meier survival analysis showed the CRM- patients had significantly better survival rate over CRM ＋ patients;the rate of CRM＋ had significant relationship with the depth of tumor invasion,tumor size,the circumferential tumor location in the rectal wall （P〈0.05）.Conclusion CRM status was a vital predictor of local recurrence,distant recurrence and survival rate. It is also related closely with the depth of cancer invasion,the size of cancer,the circumferential tumor location in the rectal walI.CRM can used as one of the risk factors for the choice of selective chemotherapy.
出处
《江西医药》
CAS
2009年第6期537-541,共5页
Jiangxi Medical Journal
关键词
中低位直肠癌
环周切缘
预后
middle and low rectal cancer
CRM
prognosis
