T1及T2期直肠癌术后复发转移分析.doc

T1及T2期直肠癌术后复发转移分析 　 作者：梁君林 万德森 潘志忠 周志伟 【摘要】 目的 探讨T1和T2期直肠癌根治术后复发转移相关的临床病理因素。方法 回顾性分析1990年至1999年146例行根治术的T1和T2期直肠癌病例的临床病理资料。结果 T1和T2期直肠癌术后复发转移率为25.3%(37/146)。T1期直肠癌复发转移率（0.0%,0/12）明显低于T2期（27.6%,37/134）（Plt;0.05）。肿瘤占肠腔周径≤50%复发率(17.9%,15/84),明显低于肿瘤占肠腔周径gt;50%(35.5%,22/62) （Plt;0.05）。低位直肠癌复发率（29.3%，34/116）明显高于中高位直肠癌（10.0%，3/30）（Plt;0.05）。而性别、年龄、病程、大体类型、组织学类型、肿瘤大小与术后复发转移无关。结论 T2期、低位、周径大于50%可能是T1和T2期直肠癌术后发生复发转移的高危因素。 【关键词】 结直肠肿瘤；复发；转移；预后 Analysis of recurrence and metastasis after curative surgery in T1/T2 colorectal cancer [Abstract] Objective To investigate the clinicopathologic factors related with recurrence and metastasis after curative surgery in T1/T2 colorectal cancer. Methods Clinicalpathologic and followup data of 146 patients with T1/T2 colorectal cancer operated with curative surgery from 1990 to 1999 were retrospectively analyzed. Results The overall recurrence rate was 25.3% (37/146).Significantly more patients with T2 rectal cancer had recurrent diseases than patients with T1 cancer (Plt;0.05). Recurrences and metastasis were more often in patients with lesions involved more than 50% of bowel wall circumference than in those less than 50% (Plt;0.05). Lower rectal cancer had higher recurrent diseases than middle and upper rectal cancer. But age, gender, symptom duration, gross findings, histological type and tumor size were not associated with recurrence and metastasis. Conclusion T2 stage, more than 50% of the rectal wall circumference involved, or low rectal cancer may be high risk factors of recurrence for T1/T2 rectal cancer patients. [Key words] Rectal neoplasms; Recurrence; Metastasis; Prognosis 直肠癌局部切除术，适用于早期(T0和T1期)直肠癌患者，另外有作者认为T2期直肠癌可行局部切除或加术后放化疗，能提高患者的生活质量[1]。T1和T2期直肠癌的治疗受到越来越多关注。本文分析1990年1月至1999年12月间146例T1、T2期直肠癌，探讨术后复发转移相关的临床病理因素，为T1和T2期直肠癌合理治疗提供依据。 1 资料与方法 收集中山大学肿瘤医院1990年1月至1999年12月间146例T1和T2期直肠癌病例。入选标准：手术性质为根治性；手术方式为经腹会阴联合切除术（abdominoperineal resection，APR）或前切除术（anterior resection，AR）；术后复发转移情况明确。排除标准：术前放化疗病例，术后放疗病例，术后3个月内复发转移或死亡病例，家族性息