Sun Zhenqiang, Yu Xianbo, Wang Haijiang, Ma Ming, Zhao Zeliang, Wang Qisan
Department of Gastrointestinal Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, Xinjiang 830011, P.R. China ; Research Laboratory of Disease Genomics, Cancer Research Institute, Central South University, Changsha, Hunan 410078, P.R. China.
Department of Gastrointestinal Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, Xinjiang 830011, P.R. China.
Exp Ther Med. 2015 Aug;10(2):484-490. doi: 10.3892/etm.2015.2552. Epub 2015 Jun 5.
The aim of the present study was to identify the factors associated with the use of sphincter-preserving resection (SPR) surgery for the treatment of low rectal cancer. A total of 330 patients with histopathologically confirmed low rectal cancer were divided into two groups, namely the abdominoperineal resection (APR) and sphincter-preserving (SP) groups. For SPR factor analysis, the χ test was performed as the univariate analysis, while a logistic regression test was conducted as the multivariate analysis. Of the 330 patients, 192 cases (58.18%) received SPR surgery and 138 cases (41.82%) underwent an APR. Univariate analysis results revealed that the sphincter-preserving factor was significantly associated with age, gender, ethnicity, body mass index (BMI), total infiltrated circumference, distance of the tumor from the anal verge (DTAV), depth of invasion and tumor grade (P<0.05). However, there were no statistically significant associations with family medical history, diabetes history, venous tumor embolism, growth type, tumor length, lymphatic metastasis and level of preoperative carcinoembryonic antigen (P>0.05). Multivariate analysis indicated that the sphincter-preserving factor was strongly associated with DTAV and the depth of invasion, with significant statistical difference (P<0.05). Therefore, selecting SPR surgery for patients with low rectal cancer is dependent on age, gender, ethnicity, BMI, the total infiltrated circumference, DTAV, depth of invasion and tumor grade. In addition, DTAV and the depth of invasion are independent risk factors for the selection of SPR surgery.
本研究的目的是确定与采用保留括约肌切除术（SPR）治疗低位直肠癌相关的因素。共有330例经组织病理学确诊的低位直肠癌患者被分为两组，即腹会阴联合切除术（APR）组和保留括约肌（SP）组。对于SPR因素分析，采用χ检验进行单因素分析，同时采用逻辑回归检验进行多因素分析。在这330例患者中，192例（58.18%）接受了SPR手术，138例（41.82%）接受了APR手术。单因素分析结果显示，保留括约肌因素与年龄、性别、种族、体重指数（BMI）、总浸润周长、肿瘤距肛缘距离（DTAV）、浸润深度和肿瘤分级显著相关（P<0.05）。然而，与家族病史、糖尿病史、静脉瘤栓、生长类型、肿瘤长度、淋巴转移和术前癌胚抗原水平无统计学显著关联（P>0.05）。多因素分析表明，保留括约肌因素与DTAV和浸润深度密切相关，差异有统计学意义（P<0.05）。因此，为低位直肠癌患者选择SPR手术取决于年龄、性别、种族、BMI、总浸润周长、DTAV、浸润深度和肿瘤分级。此外，DTAV和浸润深度是选择SPR手术的独立危险因素。
