结肠癌根治术后5年无病生存率影响因素分析
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摘要
目的研究结肠癌根治术后患者5年无病生存率影响因素。方法纳入548例接受结肠癌根治术患者作为研究对象,随访记录5年无病生存率,采用COX模型探讨影响5年无病生存率的影响因素,并对有预测价值的因素做受试者工作特征曲线(ROC),分析其准确性。结果经COX模型分析发现TNM分期、CEA及淋巴结和远处转移是影响患者术后5年无病生存率的独立因素(P<0.05)。CEA对患者5年无病生存率预测价值的ROC曲线显示,其曲线下面积(AUC)为0.866,敏感度为0.994,特异度为0.783。结论 TNM分期、CEA水平及淋巴结和远处转移是影响结肠癌根治术后5年无病生存率的高危因素,CEA水平对预测术后患者5年无病生存率有较高的应用价值。
Objective To study the predictors of 5-yar disease-free survival after radical resection of colon cancer. Methods 548 patients undergoing radical resection of colon cancer were selected as subjects. The 5-year disease-free survival were recorded and the COX multivariate analysis was used to investigate the influencing factors of disease-free survival in 5 years The receiver operating characteristic curve was used to calculate sensitivity and specificity. Results The COX multivariate analysisn showed that TNM stage,CEA and lymph node and distant metastasis were independent factors affecting disease-free survival in 5 years after operation(P <0.05). The ROC curve of CEA for predicting the 5-year disease-free survival showed that the area under the curve(AUC),sensitivity and specificity were 0.866,0.994 and 0.783,respectively. Conclusion The TNM staging,CEA level,lymph node and distant metastasis are the predictors of 5-year disease-free survival after radical resection of colon cancer. CEA level has a high value to predict the 5-year disease-free survival rate.
Objective To study the predictors of 5-yar disease-free survival after radical resection of colon cancer. Methods 548 patients undergoing radical resection of colon cancer were selected as subjects. The 5-year disease-free survival were recorded and the COX multivariate analysis was used to investigate the influencing factors of disease-free survival in 5 years The receiver operating characteristic curve was used to calculate sensitivity and specificity. Results The COX multivariate analysisn showed that TNM stage,CEA and lymph node and distant metastasis were independent factors affecting disease-free survival in 5 years after operation(P <0.05). The ROC curve of CEA for predicting the 5-year disease-free survival showed that the area under the curve(AUC),sensitivity and specificity were 0.866,0.994 and 0.783,respectively. Conclusion The TNM staging,CEA level,lymph node and distant metastasis are the predictors of 5-year disease-free survival after radical resection of colon cancer. CEA level has a high value to predict the 5-year disease-free survival rate.
引文
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[13]荆卫娟,任传路,丁磊,等.血清Tu M2-PK、TSGF与CEA、CA19-9、CA242联合检测在结肠癌诊断中的临床价值[J].标记免疫分析与临床,2015,22(11):1121-1124.
[14]王健,叶林加,李万海,等.联合检测血清CEA、CA19-9与CA72-4对老年结肠癌诊断的价值[J].中国老年学杂志,2014,4(19):5452-5453.
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[16]王晓安,肖慧杰.结肠癌患者血清CEA、CA199水平与手术治疗半年预后的相关性[J].胃肠病学和肝病学杂志,2016,25(9):998-1001.
[2]尹红,罗保平,李春亭,等.左半梗阻性结肠癌患者57例临床病理特征及其预后生存的影响因素[J].临床和实验医学杂志,2016,15(6):567-570.
[3]瞿文超,吴雪卿,冯佳梅,等.中药复方对乳腺癌患者5年无病生存率及总生存率的影响[J].中国医药导报,2012,9(36):120-122.
[4]郑树,黄彦钦.NCCN结肠癌临床诊疗指南解读[J].实用肿瘤杂志,2007,22(3):206-207.
[5]中国肥胖问题工作组.中国成人超重与肥胖症预防与控制指南[J].营养学报,2004,26(1):1-4.
[6]赵日升,汪挺.全结肠系膜切除术与传统结肠癌手术后无病生存率的比较[J].中华胃肠外科杂志,2015,7(6):572-572.
[7]李海涛,许金凤,黎春华,等.姑息治疗晚期癌症患者的预后状况及其影响因素分析[J].实用癌症杂志,2014,8(6):724-726.
[8]GOO JJ,CHOI CW,KANG DH,et al.Risk factors associated with diagnostic discrepancy of gastric indefinite neoplasia:Who need en bloc resection[J].Surgical endoscopy2015,29(12):3761-3767.
[9]叶新青,陈发龙,覃思繁,等.Survivin表达与结肠癌组织分化、TNM分期的关系[J].放射免疫学杂志,2010,23(2):188-189.
[10]CHANG JW,HONG HJ,BAN MJ,et al.Prognostic factors and treatment outc omes of parotid gland cancer:A 10-year single-center experience[J].Otola ryngology--head and neck surgery:official journal of American Academy of Otolaryngology-Head and Neck Surgery,2015,153(6):981-989.
[11]易呈浩,葛维挺,黄彦钦,等.1368例结直肠癌TNM分期及预后分析[J].结直肠肛门外科,2012,39(9):597-601.
[12]徐宏智.CEA检测对结直肠癌淋巴结微转移的临床意义[J].结直肠肛门外科,2009,47(35):11-12.
[13]荆卫娟,任传路,丁磊,等.血清Tu M2-PK、TSGF与CEA、CA19-9、CA242联合检测在结肠癌诊断中的临床价值[J].标记免疫分析与临床,2015,22(11):1121-1124.
[14]王健,叶林加,李万海,等.联合检测血清CEA、CA19-9与CA72-4对老年结肠癌诊断的价值[J].中国老年学杂志,2014,4(19):5452-5453.
[15]臧健,俞林.血清CEA水平与结直肠癌分期及分化程度的关系[J].山东医药,2013,53(43):84-85.
[16]王晓安,肖慧杰.结肠癌患者血清CEA、CA199水平与手术治疗半年预后的相关性[J].胃肠病学和肝病学杂志,2016,25(9):998-1001.