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目的探讨导致结直肠癌术后复发和转移的临床病理因素。方法通过单因素分析和多因素的Logistic回归分析方法,将结直肠癌根治术后复发或转移的104例患者(研究组)与未复发和转移患者(对照组)的临床资料进行对比分析。结果多因素的Logistic回归分析结果提示,只有Dukes分期与结直肠癌的复发相关(P=0.004);但在DukesC期中,研究组低分化腺癌和黏液腺癌比对照组显著增加(P<0.001),提示在DukesC期时,组织学类型与复发相关。Dukes分期(P=0.001)、微血管内有癌栓(P=0.020)和血清癌胚抗原(CEA)水平(P=0.010)与结直肠癌的转移相关(P值分别为0.001、0.020和0.010)。结论Dukes分期与结直肠癌术后的复发和转移均相关;而微血管内有癌栓、血清CEA水平则与结直肠癌的转移相关。
Objective To investigate the clinicopathologic factors that lead to recurrence and metastasis of colorectal cancer. Methods The clinical data of 104 patients with recurrent or metastatic colorectal cancer recurrence or metastasis (study group) and those without recurrence and metastasis (control group) were analyzed by univariate analysis and multivariate Logistic regression analysis. Results The multivariate logistic regression analysis showed that only the Dukes stage was associated with the recurrence of colorectal cancer (P = 0.004). However, in the Dukes C stage, the poorly differentiated adenocarcinomas and mucinous adenocarcinomas of the study group were significantly higher than those of the control group (P <0.001) ), Suggesting that at DukesC stage, the histological type is associated with recurrence. Dukes stage (P = 0.001), microvessel embolism (P = 0.020), and serum carcinoembryonic antigen (CEA) level (P = 0.010) were correlated with the metastasis of colorectal cancer (P = 0.001,0.020 and 0.010, respectively) . Conclusions The Dukes stage is related to the recurrence and metastasis of colorectal cancer postoperatively. However, there is a tumor thrombus in the microvascular and the serum CEA level correlates with the metastasis of colorectal cancer.