Ⅲ期结直肠癌淋巴结转移比率与预后的关系
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邱成志 E-mail:qchengzhi@sohu.com

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Relationship between metastatic lymph nodes ratio and prognosis in stage Ⅲ colorectal cancer
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    目的:探索Ⅲ期结直肠癌的淋巴结转移比率与其临床病理特征及预后的关系。方法:将247例Ⅲ期结直肠癌患者根据淋巴结转移比率(MLR)的中位数分为3个组:低比率组(≤0.21),中比率组(>0.21~0.42),高比率组(>0.42)。分析比较各组的临床病理因素和5年生存率的差别,并采用Cox比例风险模型分析Ⅲ期结直肠癌预后的相关因素。结果:247例Ⅲ期结直肠癌的淋巴结转移比率为0.02~1.00,中位数为0.21,在低比率组中,高中分化的结直肠癌的所占比例(57.9%,113/195)明显高于低分化癌的比例(23.1%,12/52)(P<0.01);≥12枚病检淋巴结的结直肠癌所占比例(56.5%,95/168)明显高于<12枚淋巴结的比例(38.0%,30/79)(P<0.05)。低比率组、中比率组、高比率组的5年生存率分别为67.4%,28.8%,6.3%,3组生存率存在明显差异(P<0.05)。多因素Cox回归模型分析表明,淋巴结转移比率是Ⅲ期结直肠癌预后的重要因素。结论:MLR是判断Ⅲ期结直肠癌预后的一个重要指标。

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    Objective: To study the relationship between metastatic lymph nodes ratio (MLR) with stage Ⅲ colorectal cancer and its clinicopathological features as well as prognosis. Methods: According to the median number of MLR, 247 patients with stage Ⅲ colorectal cancer were divided into three groups that were low-ratio (≤0.21), middle-ratio (>0.21-0.42) and high-ratio (>0.42) group, respectively. The differences of clinicopathological factors and the 5-year overall survival rate among the groups were analyzed, and the related prognostic factors of the stage Ⅲ colorectal cancer were analyzed by using Cox proportional hazards model. Results: The MLR of 247 cases ranged between 0.02-1.00 with median of 0.21. Of the low-ratio group, the proportion of the well to moderately differentiated colorectal carcinoma was 57.9% (113/195), which was significantly higher than that of the poorly differentiated colorectal carcinoma (23.1%, 12/52) (P<0.01), and the proportion of the patients who had at least 12 lymph nodes examined was 56.5% (95/168), which was significantly higher than that of the patients who had less than 12 lymph nodes examined (38.0%, 30/79) (P<0.05). The 5-year survival rate of the low-ratio, middle-ratio and high-ratio group was 67.4%, 28.8% and 6.3%, respectively, and there was a significant difference in 5-year survival rate among the three groups (P<0.05). The multivariate Cox regression model revealed that the MLR was an important factor for prognosis of stage Ⅲ colorectal cancer. Conclusions: MLR is an important parameter for determining the prognosis of stage Ⅲ colorectal cancer.

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邱成志| 吴友谊| 王春晓.Ⅲ期结直肠癌淋巴结转移比率与预后的关系[J].中国普通外科杂志,2011,20(10):1025-1028.
DOI:10.7659/j. issn.1005-6947.2011.10.001

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  • 收稿日期:2011-02-08
  • 最后修改日期:2011-09-06
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  • 在线发布日期: 2011-10-15