摘要
目的探讨腹腔镜下结肠癌根治术后环周切缘(CRM)距离对术后复发的影响。方法回顾性纳入义乌市中心医院2020年1月至2022年1月接受腹腔镜下结肠癌根治术治疗的83例患者的临床资料,依据术后1年内复发情况分为复发组(16例)与未复发组(67例),收集两组患者临床资料、术后CRM距离及实验室指标等数据,分析腹腔镜下结肠癌根治术后CRM距离对术后复发的影响。结果复发组接受术后化疗占比、术后CRM距离低于未复发组[9/16比83.58%(56/67)、(0.85±0.23)mm比(1.64±0.76)mm],入院时癌胚抗原、糖类抗原19-9水平高于未复发组[(156.74±11.58)μg/L比(149.96±10.26)μg/L、(15.63±2.77)kU/L比(14.04±2.35)kU/L],差异有统计学意义(P<0.05);经点二列相关分析验证,腹腔镜下结肠癌根治术后CRM距离与术后复发呈负相关(r=-0.412,P<0.01);多因素Logistic回归分析结果显示,术后CRM距离长是腹腔镜下结肠癌根治术后复发的保护因素(OR<1,P<0.05);绘制受试者工作特征曲线结果显示,腹腔镜下结肠癌根治术后CRM距离预测术后复发的曲线下面积=0.833>0.7,预测价值较好,当取最佳阈值1.080 mm时,可获取理想的灵敏度(87.50%)和特异度(81.00%)。结论结肠癌患者腹腔镜下根治术后CRM距离越短,患者复发风险越高,术后CRM距离可作为腹腔镜下结肠癌根治术后复发的预测指标。
Objective To investigate the effect of the distance of the circumferential resection margin(CRM)on postoperative recurrence after laparoscopic radical resection of colon cancer.Methods The clinical data of 83 patients who underwent laparoscopic radical resection of colon cancer in Yiwu Central Hospital from January 2020 to January 2022 were retrospectively included.They were divided into recurrent group(16 cases)and non-recurrent group(67 cases)according to the recurrence within 1 year after operation.The clinical data,postoperative CRM distance and laboratory indicators of the two groups were collected to analyze the influence of CRM distance on postoperative recurrence after laparoscopic radical resection of colon cancer.Results The proportion of patients treated with postoperative chemotherapy,and postoperative CRM distance in the recurrent group were lower than those in the non-recurrent group:9/16 vs.83.58%(56/67),(0.85±0.23)mm vs.(1.64±0.76)mm.The levels of CEA and CA19-9 at admission were higher than those in the non-recurrent group:(156.74±11.58)μg/L vs.(149.96±10.26)μg/L,(15.63±2.77)kU/L vs.(14.04±2.35)kU/L,and the differences were statistically significant(P<0.05).Point binary correlation analysis showed that there was a negative correlation between CRM distance and postoperative recurrence after laparoscopic radical resection of colon cancer(r=-0.412,P<0.01).Multivariate Logistic regression analysis showed that the long distance of CRM was the protective factor of recurrence after laparoscopic radical resection of colon cancer(OR<1,P<0.05).The results of the receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of the CRM distance to predict the recurrence after laparoscopic radical resection of colon cancer was 0.833>0.7,and the predictive value was good.When the optimal threshold was 1.080 mm,the ideal sensitivity and specificity could be obtained 87.50%and 81.00%.Conclusions The shorter the CRM distance after laparoscopic radical resection of colon cancer,the h
作者
李座宇
朱渊东
刘海源
卢城东
宋正明
Li Zuoyu;Zhu Yuandong;Liu Haiyuan;Lu Chengdong;Song Zhengming(Department of Anorectal Surgery,Yiwu Central Hospital,Yiwu 322000,China)
出处
《中国医师进修杂志》
2023年第10期885-889,共5页
Chinese Journal of Postgraduates of Medicine
基金
义乌市科研计划项目(20-3-165)。
关键词
结肠肿瘤
腹腔镜下结肠癌根治术
环周切缘距离
复发
Colonic neoplasms
Laparoscopic radical resection of colon cancer
Circumferential resection margin
Recurrence
