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结直肠癌根治性切除术后预后因素的回归分析

Regression analysis of prognostic factors in colorectal cancer after curative resections.

作者信息

Wiggers T, Arends J W, Volovics A

机构信息

Department of Surgery, Dr. Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.

出版信息

Dis Colon Rectum. 1988 Jan;31(1):33-41. doi: 10.1007/BF02552567.

Abstract

The clinical, laboratory, and pathologic data of 310 patients who had curative resections were prospectively collected and analyzed in a multiple stepwise regression model. Although several factors (i.e., venous invasion) were of importance in univariate analysis, the following conclusions reflect the outcome and relative importance of the regression analysis only. Blood loss as an initial symptom and duration of symptoms were associated with a better prognosis. Location of the primary tumor, age, and sex did not appear to have prognostic value. Observations during operation such as palpable lymph nodes, fixity to adjacent organs, and tumor spill were related to a diminished tumor-free survival. Laboratory data (hemoglobin, leukocytes, ESR, GGTP, SGOT, SGPT, LDH, total protein, CEA) were tested for their potential prognostic values. Only a preoperative low protein level or an elevated CEA level were associated with an increased risk of death due to recurrent tumor. The histopathologic features (stage and grade), with the exception of venous invasion, were of relative importance in the determination of prognosis. The aforementioned variables can be included in a prognostic index on the base of which high-risk groups suitable for adjuvant studies can be identified.

摘要

前瞻性收集了310例行根治性切除术患者的临床、实验室及病理数据,并采用多元逐步回归模型进行分析。尽管在单因素分析中,几个因素(如静脉侵犯)很重要,但以下结论仅反映回归分析的结果及相对重要性。以失血为初始症状及症状持续时间与较好的预后相关。原发肿瘤部位、年龄及性别似乎无预后价值。手术中的观察结果,如可触及的淋巴结、与相邻器官的粘连及肿瘤破裂与无瘤生存期缩短有关。对实验室数据(血红蛋白、白细胞、血沉、γ-谷氨酰转肽酶、谷草转氨酶、谷丙转氨酶、乳酸脱氢酶、总蛋白、癌胚抗原)进行了潜在预后价值检测。仅术前低蛋白水平或癌胚抗原水平升高与因肿瘤复发导致的死亡风险增加有关。除静脉侵犯外,组织病理学特征(分期及分级)在判断预后方面相对重要。上述变量可纳入预后指数,据此可识别适合辅助研究的高危组。

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