直肠癌根治术后局部复发的临床多因素分析

目的 探讨直肠癌根治术后局部复发的相关临床病理因素,以提高直肠癌根治疗效.方法 回顾性分析1995年1月至2002年12月257例直肠癌根治术后患者的临床病理资料,应用两分类反应变量Logistic回归(前进法)建立单因素和多因素回归分析模型,探讨各临床病理特征与术后局部复发的关系.结果 直肠癌根治术后局部复发率为18.7%,中位时间14.6(2～63)个月;术后2年内复发率75.0%(36/48),3年内复发率95.8%(45/48).单因素回归分析显示年龄、Dukes分期、淋巴结转移、癌胚抗原水平与直肠癌根治术后局部复发有关(均P<0.05);多因素回归分析显示年龄、淋巴结转移是影响直肠癌根治术后局部复发的重要因素(均P<0.05).结论 年龄和淋巴结转移是影响直肠癌患者术后局部复发重要的因素,加强早期诊断和科学、规范的治疗有望改善直肠癌预后.

Clinical multivariate regression analysis of local recurrence following curative surgery for rectal cancer

Objective To investigate the clinicopathologic factors related to local recurrence following curative surgery for rectal cancer and explore the ways to improve the efficacies. Methods A total of 257 post-operative cases of rectal cancers from January 1995 to December 2002 were recruited. And the relation of each clinicopathologic characteristic and local post-operative recurrence was retrospectively investigated. The clinicopathologic factors and follow-up data were analyzed by uni and multi-factorial regression model by logistic regression. Results The total local recurrence rate of rectal cancer after radical operation was 18.7% , 75.0% (36/48)within 2 years and 95. 8% (45/48)within 3 years, the median time was 14. 6 months (range: 2-63). Univariate analysis showed that age, Dukes' stage, lymph node metastasis and level of CEA were significantly associated with the local post-operative recurrence ( P < 0. 05 ). Mutivariate analysis showed that age and lymph node metastasis were closely related with the local post operative recurrence ( P < 0. 05 ). Conclusion Lymph node metastasis and age are very important prognostic factors for the local post-operative recurrence. It is possible to improve the prognosis of rectum cancer by making an early diagnosis and offering a scientific standard therapy.