摘要
目的探讨不同T分期结直肠癌发生肝肺同时转移患者的临床病理特征及其对预后的影响。方法收集监测、流行病学与最终结果(SEER)数据库中2010年至2015年登记的结直肠癌发生肝肺转移2602例患者的临床资料。根据T分期分为T0/T1期组545例、T2/T3期组1138例、T4期组919例。对比3组在年龄、性别、种族、原发灶部位、组织学分型、分化程度、T和N分期、远处转移部位、血清癌胚抗原、手术情况、总生存期等临床病理特征上的差异,并采用Kaplan-Meier法和COX回归分析不同T分期对患者预后的影响。结果T0/T1期组出现N2分期的比例显著低于T2/T3期组和T4期组[3.5%(19/545)比29.3%(333/1138),χ^(2)=379.911,P<0.05;3.5%(19/545)比32.4%(298/919),χ^(2)=379.911,P<0.05]。T4期组位于直肠的比例显著低于T0/T1期组和T2/T3期组[18.6%(167/899)比32.8%(165/503),χ^(2)=64.569,P<0.05;18.6%(167/899)比33.9%(382/1127),χ^(2)=64.569,P<0.05]。在分化程度上,3组中T0/T1期组Ⅳ级比例最低,T4期组Ⅲ级和Ⅳ级比例最高。COX回归表明T0/T1期组[风险比(HR)=1.130,95%可信区间(CI):1.001~1.275,P<0.05]和T4期组(HR=1.190,95%CI:1.085~1.305,P<0.01)相较于T2/T3期组具有显著更差的预后。结论不同T分期结直肠癌发生肝肺转移患者的临床病理特征及预后差异显著,尤其是T0/T1期患者具有更低的淋巴结转移比例和更差的预后。
Objective To explore the clinicopathological characteristics and prognosis of colorectal cancer with liver and lung metastases according to different T stage.Methods The information of 2602 patients with colorectal cancer with liver and lung metastases registered in the surveillance,epidemiology and end results(SEER)database from 2010 to 2015 was collected.All the patients were divided into three groups according to T stage:T0/T1 group(n=545),T2/T3 group(n=1138),and T4 group(n=919).The clinicopathological characteristics(including age,sex,race,primary tumor site,histology,differential stage,T/N stage,distant metastatic site,carcinoembryonic antigen,surgery,and overall survival)were compared across the three groups and the impact of T stage on the overall survival was detected by Kaplan-Meier method and COX logistical analysis.Results The proportion of N2 in T0/T1 group was significantly lower than those in T2/T3 group and T4 group[3.5%(19/545)vs.29.3%(333/1138),χ^(2)=379.911,P<0.05;3.5%(19/545)vs.32.4%(298/919),χ^(2)=379.911,P<0.05].The proportion of rectum location in T4 group was significantly lower than those in T0/T1 group and T2/T3 group[18.6%(167/899)vs.32.8%(165/503),χ^(2)=64.569,P<0.05;18.6%(167/899)vs.33.9%(382/1127),χ^(2)=64.569,P<0.05].Among the three groups,the proportion of gradeⅣin T0/T1 group was the lowest,and the proportion of gradeⅢandⅣin T4 group was the highest.COX logistical analysis indicated that T0/T1 group[hazard ratio(HR)=1.130,95%confidence interval(CI):1.001-1.275,P<0.05]and T4 group[HR=1.190,95%CI:1.085-1.305,P<0.01]showed a significantly poorer prognosis compared with T2/T3 group.Conclusion Patients with colorectal cancer with liver and lung metastases in the different T stage presented significantly different clinicopathological characteristics and prognosis,especially for T0/T1 stage that has lower proportion of N2 and poorer prognosis.
作者
郑款恒
钟平
李峰
雷新键
杨千洪
何聪
李瑾
Zheng Kuanheng;Zhong Ping;Li Feng;Lei Xinjian;Yang Qianhong;He Cong;Li Jin(Department of Oncosurgery,Ningde Hospital Affiliated to Ningde Normal University,Ningde 352100,China;BE and Phase I Clinical Trial Center,the First Affiliated Hospital of Xiamen University,Xiamen 361000,China)
出处
《中华实验外科杂志》
CAS
北大核心
2022年第4期710-715,共6页
Chinese Journal of Experimental Surgery
关键词
结直肠癌
肝转移
肺转移
预后
Colorectal cancer
Liver metastasis
Lung metastasis
Prognosis
