Wang Q A
Dept. General Surgery, Chang Zheng Hospital, Second Military Medical University, Shanghai.
Zhonghua Zhong Liu Za Zhi. 1991 Jul;13(4):302-5.
The influence of nine clinico-pathological factors on anastomotic recurrence of rectal cancer after anterior resection was analyzed using Cox regression model. Among the nine factors, the mucin histochemical changes in mucosa at the resection margins, Dukes' stage and histological type of the cancer were of significance (P less than 0.1). The most important variable for anastomotic recurrence was mucin histochemical changes at the resection margins according to the Wald statistic value. It is suggested that the transitional mucosa adjacent to rectal carcinoma in which mucin histochemical changes take place bears great weight on the further malignant transformation after anterior resection. The biological characteristics of the transitional mucosa and clinical significance of the application of Cox regression model for prognostic analysis are discussed.
采用Cox回归模型分析9个临床病理因素对直肠癌前切除术后吻合口复发的影响。在这9个因素中,切缘黏膜的黏蛋白组织化学变化、Dukes分期及癌组织学类型具有显著性意义(P小于0.1)。根据Wald统计值,切缘黏蛋白组织化学变化是吻合口复发最重要的变量。提示发生黏蛋白组织化学变化的直肠癌旁移行黏膜对前切除术后进一步恶变起重要作用。文中讨论了移行黏膜的生物学特性及应用Cox回归模型进行预后分析的临床意义。