本文關(guān)鍵詞： 結(jié)腸腫瘤 壁外血管侵犯 CA- 無病生存　出處：《中國(guó)實(shí)用外科雜志》2017年01期 　論文類型：期刊論文

【摘要】：目的探索增強(qiáng)多排螺旋CT(ce MDCT)診斷結(jié)腸癌壁外血管侵犯(EMVI)預(yù)測(cè)病人3年無病生存(DFS)的價(jià)值。方法收集北京大學(xué)人民醫(yī)院胃腸外科2009年2月至2013年12月間接受根治性手術(shù)切除并經(jīng)病理學(xué)檢查證實(shí)的90例原發(fā)性結(jié)腸癌病人的臨床病理資料及術(shù)前影像學(xué)資料。根據(jù)術(shù)前ce MDCT影像特征確定結(jié)腸癌EMVI陽(yáng)性為結(jié)腸癌塊直接侵犯至結(jié)腸壁外血管腔內(nèi)。Kaplan-Meier法比較結(jié)腸癌病人3年DFS差異;Cox比例風(fēng)險(xiǎn)模型單因素、多因素分析結(jié)腸癌病人3年DFS的相關(guān)因素及獨(dú)立預(yù)測(cè)因素;卡方檢驗(yàn)比較結(jié)腸癌病人的復(fù)發(fā)轉(zhuǎn)移發(fā)生率。結(jié)果根據(jù)美國(guó)癌癥聯(lián)合委員會(huì)(AJCC)的標(biāo)準(zhǔn),經(jīng)病理診斷為Ⅲ期的90例結(jié)腸癌病人納入本回顧性研究。Cox多因素模型分析發(fā)現(xiàn),ce MDCT診斷EMVI陽(yáng)性(HR=3.266,95%CI 1.648~7.173,P=0.003)和術(shù)前血清CA19-9≥37 k U/L(HR=2.229,95%CI 1.040~4.776,P=0.039)是預(yù)測(cè)Ⅲ期結(jié)腸癌病人3年DFS的獨(dú)立危險(xiǎn)因素。EMVI陽(yáng)性組及陰性組的3年DFS分別為52.8%和81.5%,二者差異具有統(tǒng)計(jì)學(xué)意義(P0.05);EMVI陰性聯(lián)合血清CA 19-9正常的病人3年復(fù)發(fā)轉(zhuǎn)移發(fā)生率為10.5%,顯著低于EMVI陽(yáng)性聯(lián)合血清CA19-9升高的病人(54.5%,P0.05)。結(jié)論 CT診斷EMVI陽(yáng)性和術(shù)前血清CA19-9升高是Ⅲ期結(jié)腸癌術(shù)后3年DFS的獨(dú)立預(yù)后危險(xiǎn)因素,可此對(duì)Ⅲ期結(jié)腸癌可進(jìn)行更準(zhǔn)確的風(fēng)險(xiǎn)分層。
[Abstract]:Objective to explore the value of enhanced multislice spiral CT(ce (MDCT) in the diagnosis of extramural vascular invasion of colon cancer (EMVI) in predicting the 3-year disease-free survival of patients. Methods from February 2009 to December 2013, the indirect radical resection of gastrointestinal surgery in the people's Hospital of Peking University was collected. Clinicopathological data and preoperative imaging data of 90 patients with primary colon cancer proved by surgical resection and pathological examination. According to the features of preoperative ce MDCT imaging, it was confirmed that the positive EMVI of colon cancer was the direct invasion of colon cancer to colon. Kaplan-Meier method was used to compare 3-year DFS difference in colon cancer patients. Multivariate analysis of the related factors and independent predictive factors of 3-year DFS in colon cancer patients, chi-square test was used to compare the recurrence and metastasis rate of colon cancer patients. 90 patients with colon cancer diagnosed by pathology in stage 鈪，

本文編號(hào)：1527023