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目的探讨T1和T2期直肠癌患者的临床病理特征与预后的关系。方法选取2007年1月至2010年10月间南华大学第二附属医院外科收治的289例直肠癌患者,所有患者均经术前活检和(或)术后病理检查确诊。采用人访、电话和信件相结合的方式进行随访,术后第1年内每3个月随访1次,第2年始每6个月随访1次,建立完整的个人记录档案。采用单因素分析方法,比较不同年龄、性别、肿瘤直径、肿瘤组织学分型、肿瘤形态、肿瘤分化程度及肿瘤-淋巴结-转移(TNM)分期患者间生存率是否存在统计学意义,将有意义的变量引入Cox回归模型,筛选出影响生存预后的独立因素。结果不同年龄、肿瘤形态、肿瘤分化程度及TNM分期的患者间生存率的差异有统计学意义(P<0.05),而患者性别、肿瘤直径与肿瘤的组织学分型对患者手术后生存率差异无统计学意义(P>0.05)。肿瘤分化程度与TNM分期为影响生存预后的独立性因素(P<0.05)。结论直肠癌的肿瘤分化程度与TNM分期为影响直肠癌预后的独立危险因素,而患者年龄、性别、肿瘤直径、肿瘤形态和肿瘤的组织学分型等因素与患者预后无关,差异无统计学意义(P>0.05)。
Objective To investigate the relationship between the clinicopathological characteristics and prognosis of T1 and T2 rectal cancer. Methods A total of 289 patients with rectal cancer admitted to the Second Affiliated Hospital of Nanhua University from January 2007 to October 2010 were selected. All patients were confirmed by preoperative biopsy and / or postoperative pathological examination. Follow-up was conducted by a combination of person-to-person visit, telephone call and letter, followed up every 3 months during the first year and followed up every 6 months from the second year to establish a complete personal record file. Univariate analysis was used to compare the survival rates of patients with different ages, genders, tumor diameters, tumor histological types, tumor morphology, tumor differentiation and tumor-lymph node-metastasis (TNM) staging. The variables were introduced into Cox regression model to screen out the independent factors influencing survival prognosis. Results The survival rates of patients with different ages, tumor types, tumor differentiation degree and TNM stage were significantly different (P <0.05), while the gender, tumor diameter and tumor histological type had no significant differences Statistical significance (P> 0.05). The degree of tumor differentiation and TNM stage were the independent factors influencing the prognosis of survival (P <0.05). Conclusion The degree of tumor differentiation and TNM stage are the independent risk factors affecting the prognosis of rectal cancer. The factors such as age, sex, tumor diameter, tumor morphology and tumor histological type have no relationship with the prognosis of patients with no significant difference P> 0.05).