结直肠癌患者腹部计算机断层扫描征象与术后预后的相关性
Correlation between abdominal computed tomography signs and postoperative prognosis for patients with colorectal cancer.
作者信息
Yang Shao-Min, Liu Jie-Mei, Wen Rui-Ping, Qian Yu-Dong, He Jing-Bo, Sun Jing-Song
机构信息
Department of Radiology, Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University, Foshan 528315, Guangdong Province, China.
Department of Rehabilitation Medicine, Shunde Hospital, Southern Medical University, Foshan 528399, Guangdong Province, China.
出版信息
World J Gastrointest Surg. 2024 Jul 27;16(7):2145-2156. doi: 10.4240/wjgs.v16.i7.2145.
BACKGROUND
Patients with different stages of colorectal cancer (CRC) exhibit different abdominal computed tomography (CT) signs. Therefore, the influence of CT signs on CRC prognosis must be determined.
AIM
To observe abdominal CT signs in patients with CRC and analyze the correlation between the CT signs and postoperative prognosis.
METHODS
The clinical history and CT imaging results of 88 patients with CRC who underwent radical surgery at Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University were retrospectively analyzed. Univariate and multivariate Cox regression analyses were used to explore the independent risk factors for postoperative death in patients with CRC. The three-year survival rate was analyzed using the Kaplan-Meier curve, and the correlation between postoperative survival time and abdominal CT signs in patients with CRC was analyzed using Spearman correlation analysis.
RESULTS
For patients with CRC, the three-year survival rate was 73.86%. The death group exhibited more severe characteristics than the survival group. A multivariate Cox regression model analysis showed that body mass index (BMI), degree of periintestinal infiltration, tumor size, and lymph node CT value were independent factors influencing postoperative death ( < 0.05 for all). Patients with characteristics typical to the death group had a low three-year survival rate (log-rank = 66.487, 11.346, 12.500, and 27.672, respectively, < 0.05 for all). The survival time of CRC patients was negatively correlated with BMI, degree of periintestinal infiltration, tumor size, lymph node CT value, mean tumor long-axis diameter, and mean tumor short-axis diameter ( = -0.559, 0.679, -0.430, -0.585, -0.425, and -0.385, respectively, < 0.05 for all). BMI was positively correlated with the degree of periintestinal invasion, lymph node CT value, and mean tumor short-axis diameter ( = 0.303, 0.431, and 0.437, respectively, < 0.05 for all).
CONCLUSION
The degree of periintestinal infiltration, tumor size, and lymph node CT value are crucial for evaluating the prognosis of patients with CRC.
背景
不同分期的结直肠癌（CRC）患者表现出不同的腹部计算机断层扫描（CT）征象。因此，必须确定CT征象对CRC预后的影响。
目的
观察CRC患者的腹部CT征象，并分析CT征象与术后预后之间的相关性。
方法
回顾性分析南方医科大学顺德医院附属杏坛医院88例行根治性手术的CRC患者的临床病史和CT影像结果。采用单因素和多因素Cox回归分析探讨CRC患者术后死亡的独立危险因素。采用Kaplan-Meier曲线分析三年生存率，并采用Spearman相关分析分析CRC患者术后生存时间与腹部CT征象之间的相关性。
结果
CRC患者的三年生存率为73.86%。死亡组的特征比生存组更严重。多因素Cox回归模型分析显示，体重指数（BMI）、肠周浸润程度、肿瘤大小和淋巴结CT值是影响术后死亡的独立因素（均P<0.05）。具有死亡组典型特征的患者三年生存率较低（对数秩检验χ²分别为66.487、11.346、12.500和27.672，均P<0.05）。CRC患者的生存时间与BMI、肠周浸润程度、肿瘤大小、淋巴结CT值、肿瘤平均长径和肿瘤平均短径呈负相关（r分别为-0.559、0.679、-0.430、-0.585、-0.425和-0.385，均P<0.05）。BMI与肠周侵犯程度、淋巴结CT值和肿瘤平均短径呈正相关（r分别为0.303、0.431和0.437，均P<0.05）。
结论
肠周浸润程度、肿瘤大小和淋巴结CT值对评估CRC患者的预后至关重要。
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