Abstract
目的 探讨影响青年人直肠癌预后的因素.方法分析一个肿瘤中心 10年间经手术治疗的 168例 40岁以下直肠癌病例的临床病理特征,对影响患者生存的多种因素进行了单因素及多因素分析.结果 168例中, 病理根治术( R0) 130例( 77.4%),镜下切端阳性( R1) 12例( 7.1%),大体标本切端阳性( R2) 26例( 15.5%).低位前切除术 57例, Miles术 89例,单纯行乙状结肠造瘘术 22例;手术死亡率为 0.随访期间发生肝转移 10例,肺转移 6例,骨转移 1例. 81例患者于术后 87个月内死于复发和转移.患者的平均生存时间为( 67.0± 3.8)个月. 5年和 10年总生存率分别为 44.3%及 37.0%.单因素分析表明,术式、肿瘤根治度、肿瘤病理类型、肿瘤直径、肿瘤侵犯深度、淋巴结转移、远处转移、肝转移及 TNM分期为影响预后的因素;多因素回归分析显示,仅有肿瘤根治度及淋巴结转移是影响患者术后生存的独立因素.结论影响直肠癌患者术后生存的因素为术式、肿瘤的根治度、病理类型、肿瘤直径、肿瘤侵犯深度、淋巴结转移、远处转移、肝转移及 TNM分期.其中独立影响因素仅有肿瘤的根治度及淋巴结转移。
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