Prognostic difference in colorectal cancer patients with or without lymphovascular invasion
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摘要: 目的 比较结直肠癌手术切除标本中的脉管癌栓阳性患者与阴性患者预后差异。 方法 回顾性分析2005~2010年温州医科大学附属台州医院胃肠外科手术治疗的结直肠癌患者临床病理资料,用单因素分析探讨脉管癌栓和临床病理资料的关系。对可能影响患者生存的因素进行单因素和Cox多因素模型分析,分析可能影响结直肠癌预后的因素。Kaplan-Meie生存分析阳性脉管癌栓和结直肠癌患者生存预后关系。 结果 单因素方差分析发现:癌栓的发生率与肿瘤分化程度(P=0.01),淋巴结转移(P<0.001),TNM分期(P<0.001)关系密切,癌栓的发生同样和结直肠癌患者的生存率(P<0.001)有密切关系。Cox多危险因素回归分析发现:癌栓(P=0.001),淋巴结转移(P=0.025),TNM分期(P<0.001)可以作为结直肠癌患者的独立预后危险因素;从Kaplan-Meie生存分析中发现:脉管癌栓阴性的患者的生存率明显高于存在脉管癌栓阳性的患者(P<0.001)。 结论 脉管癌栓与淋巴结的转移关系密切,脉管癌栓阳性明显影响患者的生存预后,并且脉管癌栓可以作为结直肠癌患者的独立预后因素;因此我们认为针对此类高危患者,临床上应采取更积极更具有针对性的治疗来提高患者的生存质量和延长患者的生存时间。Abstract: Objective To investigate the prognostic difference of colorectal cancer patients with or without lymphovascular invasion after the surgical treatment. Methods The clinicopathological data of colorectal cancer patients in our hospital between 2005 and 2010 were retrospectively analyzed.The relationship between lymphovascular invasion and clinical parameters were analyzed with ANOVA.Univariate and Cox multivariate analysis were also conducted to identify the prognostic factor of colorectal cancer patients.Kaplan-Meie was performed to investigate the correlation between lymphovascular invasion-positive and the prognosis of patients. Results ANOVA showed that lymphovascular invasion closely related to tumor differentiation(P=0.01),lymphatic metastasis(P<0.001),TNM(P<0.001) and survival rate(P<0.001).Cox regression analysis showed that lymphovascular invasion(P=0.001),lymphatic metastasis(P=0.025),TNM stage(P<0.001) were the independent prognostic factor for colorectal cancer patients.Kaplan-Meie analysis of lymphovascular invasion demonstrated that the patients with lymphovascular invasion-positive had a significantly shorter survival time than those with lymphovascular invasion-negative patients(P<0.001). Conclusion Lymphovascular invasion had a compact relationship with lymphatic metastasis,and the positive-lymphovascular invasion might be a potential independent prognostic factor for patients with colorectal cancer.The more efficient therapy and method for colorectal cancer patients with positive lymphovacular invasion should be adopt to improve living standard and prolong survival time.
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Key words:
- Lymphovascular invasion /
- Colorectal cancer /
- Lymphatic metastasis /
- Prognosis
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