结直肠癌的CT表现及其与临床病理分级、患者预后的关系

目的探讨结直肠癌的CT表现及其与临床病理参数、患者预后的关系。方法回顾性分析137例结直肠癌患者临床资料,所有患者均经手术病理证实,术前进行CT扫描,统计CT征象中肠壁增厚形式、强化程度、增强后低密度区、淋巴结位置、肠周浸润程度、肿瘤大小、淋巴结CT值、平均长径、平均短径,分析其与病理分级结果的关系,并对2组患者进行3年随访,比较生存组与死亡组患者CT征象差异。结果137例患者经病理结果证实包括Ⅰ级患者41例,Ⅱ级51例,Ⅲ级45例;Logisitic回归分析显示重度肠周浸润、肿瘤大小≥4 cm、淋巴结CT值≥30 HU、平均长径≥0.6 cm、平均短径≥0.45 cm是导致结直肠癌患者高病理分级的危险因素。137例患者3年随访期间内生存104例,死亡33例,3年总生存率为75.91%;Logisitic回归分析显示重度肠周浸润、肿瘤大小≥4 cm、淋巴结CT值≥30 HU、平均长径≥0.6 cm、平均短径≥0.45 cm是导致结直肠癌患者死亡的危险因素。结论CT检查可充分显示肿瘤内部状态以及其与相邻组织之间的关系,可判断肠周浸润程度、肿瘤大小、淋巴结CT值、平均长径、平均短径,对评价结直肠癌病理分级、患者预后具有重要价值。

CT Findings of Colorectal Cancer and Their Relationship with ClinicopathologicalGrading and Prognosis

Objective To explore the CT findings of colorectal cancer and their relationship with clinicopathological parameters and prognosis.Methods The clinical data of 137 patients with colorectal cancer were retrospectively analyzed.All patients were confirmed by surgery and pathology.CT scan was performed before surgery.CT signs were statistically analyzed,including intestinal wall thickening form,enhancement degree,low-density area after enhancement,lymph node location,perienteric infiltration degree,tumor size,lymph node CT value,mean long diameter and mean short diameter.Their relationship with pathological grading results was analyzed.The patients in both groups were followed up for 3 years.The differences in CT signs were compared between survival group and death group.Results Of the 137 patients confirmed by pathological results,there were 41 cases,51 cases and 45 cases at grade I,II and III,respectively.Logisitic regression analysis showed that severe perienteric infiltration,tumor size not shorter than 4cm,lymph node CT not lower than 30HU,mean long diameter not shorter than 0.6cm and mean short diameter not shorter than 0.45 cm were risk factors which lead to high pathological grading in colorectal cancer patients.Of the 137 patients during 3-year follow-up,there were 104 cases survived and 33 cased dead.The 3-year overall survival rate was 75.91%.Logisitic regression analysis showed that severe perienteric infiltration,tumor size not shorter than 4 cm,lymph node CT not lower than 30HU,mean long diameter not shorter than 0.6cm and mean short diameter not shorter than 0.45 cm were risk factors of death in colorectal cancer patients.Conclusion CT examination can fully display internal status of tumors and their relationship with adjacent tissues.It can determine perienteric infiltration degree,tumor size,CT value of lymph nodes,mean long diameter and mean short diameter,which is of important value in evaluating pathological grading and prognosis of colorectal cancer.