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目的探讨影响结直肠癌同时性腹膜转移的临床病理学特征。方法回顾性收集2010~2014年期间南京大学医学院附属鼓楼医院集团宿迁市人民医院普外科和南京大学医学院附属鼓楼医院普外科收治的1 593例结直肠癌患者的临床资料,采用非条件logistic回归分析结直肠癌同时性腹膜转移的影响因素。结果 1 593例结直肠癌患者中,发生同时性腹膜转移40例(2.5%)。单因素分析结果显示:年龄、肿瘤直径、CEA水平、CA19-9水平、CA-125水平、T分期、分化程度、病理学类型及合并糖尿病情况均是腹膜转移的影响因素(P<0.05),年龄≥65岁、肿瘤直径≥5 cm、CEA水平增高、CA19-9水平增高、CA-125水平增高、肿瘤T分期越晚、分化程度越低、印戒细胞癌/黏液腺癌及合并糖尿病患者的同时性腹膜转移率较高。logistic回归分析结果显示:CEA水平、CA-125水平、T分期、合并糖尿病、分化程度及病理学类型均是结直肠癌同时性腹膜转移的影响因素(P<0.05),CEA水平增高、CA-125水平增高,T分期越晚、低分化(相对于高分化)、黏液腺癌(相对于腺癌)及合并糖尿病者的腹膜转移率较高。结论 CEA水平增高、CA-125水平增高、肿瘤T分期、低分化、黏液腺癌及合并糖尿病均是结直肠癌同时性腹膜转移的危险因素。
Objective To investigate the clinicopathological features of concurrent peritoneal metastasis of colorectal cancer. Methods The clinical data of 1 593 patients with colorectal cancer who were admitted to Department of General Surgery, Suqian People’s Hospital, Drum Tower Hospital affiliated to Nanjing University Medical College and General Hospital of Gulou Hospital affiliated to Nanjing Medical University from 2010 to 2014 were retrospectively collected. The clinical data of non-conditional logistic Regression Analysis of Factors Affecting Simultaneous Peritoneal Metastasis in Colorectal Cancer. Results Among 1 593 colorectal cancer patients, 40 cases (2.5%) had simultaneous peritoneal metastasis. Univariate analysis showed that age, tumor diameter, CEA level, CA19-9 level, CA-125 level, T stage, differentiation degree, pathological type and diabetes mellitus were the influencing factors of peritoneal metastasis (P <0.05) Age ≥ 65 years old, tumor diameter ≥ 5 cm, CEA level increased, CA19-9 level increased, CA-125 levels increased, the later the tumor T stage, the lower the degree of differentiation, signet ring cell carcinoma / mucinous adenocarcinoma and patients with diabetes Concomitant peritoneal metastasis rate higher. The results of logistic regression analysis showed that CEA level, CA-125 level, T stage, diabetes mellitus, differentiation degree and pathological type were the influential factors of simultaneous peritoneal metastasis of colorectal cancer (P <0.05) Increased levels of 125, late T stage, peritoneal metastasis of poorly differentiated (compared to well-differentiated), mucinous adenocarcinoma (relative to adenocarcinoma) and those with diabetes mellitus were higher. Conclusions CEA level increased, CA-125 level increased, tumor T stage, poorly differentiated, mucinous adenocarcinoma and diabetes mellitus were all risk factors for simultaneous peritoneal metastasis of colorectal cancer.