DukesB期结直肠癌根治术后复发转移分析(精选).docVIP

KKME---专业医学搜索引擎/ Dukes B期结直肠癌根治术后复发转移分析 Dukes B期结直肠癌根治术后复发转移分析 作者：梁君林 万德森 陈利生 潘志忠 周志伟　 作者单位：1 530021 南宁，广西医科大学一附院结直肠肛门外科； 2 510060 广州，中山大学肿瘤防治中心腹科 【摘要】 目的 探讨Dukes B期结直肠癌根治术后复发转移相关的临床病理因素。方法 应用单因素分析法，回顾性分析1990-1999年265例Dukes B期结直肠癌根治术病例的临床病理因素。结果 单因素分析显示，Dukes B期大肠癌的预后与肿瘤部位有关，直肠癌术后更易发生复发转移，特别是局部复发。而性别、年龄、病程、大体类型、肿瘤大小、组织学类型、分化程度、肠壁浸润深度与术后复发转移无关。结论 Dukes B期的直肠癌患者术后局部复发的风险较大。 【关键词】 结直肠癌 根治术 复发 转移 Analysis of recurrence of Dukes B colorectal cancer following radical surgery LIANG Junlin, WAN Deshen, CHEN Lisheng, PAN Zhizhong, ZHOU Zhiwei. Department of Colorectal and Anal Surgery, First Affiliated Hospital, Guangxi Medical University, Nanning 530021, China 【Abstract】 Objective To investigate the clinicopathologic factors leading to recurrence of Dukes B (T3-4N0M0) colorectal cancer following radical surgery. Methods Clinicalpathological factors leading to recurrence in 265 cases with colorectal cancer at Dukes B treated with radical surgery from 1990 to 1999 were retrospectively analyzed by using univariate method. There were 220 cases without recurrence and 45 with recurrence. Results Univariate analysis showed that prognosis of colorectal cancer at Dukes B was significantly associated with site of tumor. Tumor recurrence and metastasis, especially local metastasis, could easily occur after surgery for rectal cancer. Yet, age, gender, symptom duration, gross findings, histological differentiation, tumor size and depth of bowel wall invasion were not associated with tumor recurrence. Conclusion Cases with rectal cancer at stage of Dukes B have additional risks for postoperative local recurrence. 【Key words】 Colorectal cancer; Radical surgery; Recurrence; Metastasis 目前Dukes及TNM (International Union Against Cancer，UICC，国际抗癌联盟)分期是应用最广泛的结直肠癌分期系统，以肠壁的侵犯和淋巴结的受累为基础。尽管目前结直肠癌患者的预后判断主要依靠临床病理分期，但越来越多的研究结果表明，这种仅以形态学为基础的分期方法不足以预测临床结果，特别是Dukes B期(Ⅱ期，T3～4N0M0)病例［1］。Dukes B期约占大肠癌的40%～50%。在Dukes B期分期内存在异质性，患者的预后有很大的差异，大约