摘要
目的探索影响局部进展期直肠癌新辅助放化疗后生存预后的临床影响因素。方法回顾性分析2007年4月至2015年5月间北京医院和北京大学第一医院普通外科收治的87例接受新辅助放化疗的中低位局部进展期直肠癌患者的临床资料，分析其对3年无病生存期（DFS）、总生存期（OS）的影响。结果全组患者中有83例完成了全部治疗，Kaplan-Meier法生存分析显示，患者性别（P＝0.315，P＝0.195）、年龄（P＝0.358，P＝0.641）、新辅助放化疗前癌胚抗原（CEA）（P＝0.790，P＝0.315）和CA19-9（P＝0.238，P＝0.701）、手术前CA19-9（P＝0.701，P＝0.452）、TRG Deworak分级（P＝0.422，P＝0.211）、是否pCR（P＝0.216，P＝0.280）、T分期（P＝0.336，P＝0.476）、TNM分期（P＝0.171，P＝0.171）、局部浸润因素（P＝0.438，P＝0.053）对3年DFS、OS的影响差异无统计学意义。术后淋巴结转移阳性对3年的DFS的影响差异有统计学意义（95.2%与69.5%，χ2＝8.642，P＝0.003）。手术前低CEA水平对3年的OS的影响差异有统计学意义（90.9%与66.7%，χ2＝8.820，P＝0.003）。多因素Cox回归分析显示，术前CEA水平是影响OS的独立危险因素（P＝0.035）。结论术前CEA水平是影响OS的独立危险因素。
ObjectiveTo evaluate the clinical predictive factors for survival prognosis in patients with locally advanced rectal cancer after neoadjuvant chemoradiotheraphy.
MethodsThe study included 87 patients with middle and lower locally advanced rectal cancer, who underwent neoadjuvant chemoradiotheraphy followed by radical surgery between April 2007 and May 2015. The clinical factors associated with 3-year disease-free survival （DFS） and overall survival （OS） were analyzed.Kaplan-Meier analysis of disease-free survival and overall survival was performed for all patients.ResultsThe 3-year DFS was significantly improved in patients with negative lymph node（95.2% vs 69.5%, χ2=8.642, P=0.003）. The 3-year OS was better in the patients with lower serum level of pre- chemoradiotheraphy carcino-embryonic antigen （CEA）（90.9% vs 66.7%, χ2=8.820, P=0.003）. Cox regression multivariate analysis revealed that serum level of pre-chemoradiotheraphy CEA was an independent predictive factor for 3-year OS（P=0.035）.ConclusionSerum level of pre- chemoradiotheraphy CEA is an independent risk factor for 3-year OS.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2017年第10期739-742,共4页
National Medical Journal of China
关键词
直肠肿瘤
新辅助放化疗
预后
Rectal neoplasms
Neoadjuvant chemoradiotherapy
Prognosis
