背景:患有不同阶段的结直肠癌(CRC)的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:观察结直肠癌患者腹部CT征象,分析CT征象与术后预后的相关性。
方法:回顾性分析南方医科大学顺德医院附属杏坛医院行根治性手术的88例CRC患者的病史和CT影像学检查结果。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。3年生存率采用Kaplan-Meier曲线分析,并采用Spearman相关分析法分析CRC患者术后生存时间与腹部CT征象的相关性。
结果:对于CRC患者,3年生存率为73.86%。死亡组比生存组表现出更严重的特征。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,淋巴结CT值是影响术后死亡的独立因素(均P<0.05)。具有典型特征的死亡组患者的三年生存率较低(log-rankχ2分别为66.487、11.346、12.500和27.672,全部P<0.05)。结直肠癌患者的生存时间与BMI呈负相关,肠周浸润程度,肿瘤大小,淋巴结CT值,平均肿瘤长轴直径,和平均肿瘤短轴直径(r分别为-0.559、0.679、-0.430、-0.585、-0.425和-0.385,全部P<0.05)。BMI与肠周浸润程度呈正相关,淋巴结CT值,和平均肿瘤短轴直径(r分别为0.303、0.431和0.437,全部P<0.05)。
结论:肠周浸润程度,肿瘤大小,淋巴结CT值对评估CRC患者的预后至关重要。
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.
OBJECTIVE: 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 (P < 0.05 for all). Patients with characteristics typical to the death group had a low three-year survival rate (log-rank χ 2 = 66.487, 11.346, 12.500, and 27.672, respectively, P < 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 (r = -0.559, 0.679, -0.430, -0.585, -0.425, and -0.385, respectively, P < 0.05 for all). BMI was positively correlated with the degree of periintestinal invasion, lymph node CT value, and mean tumor short-axis diameter (r = 0.303, 0.431, and 0.437, respectively, P < 0.05 for all).
CONCLUSIONS: The degree of periintestinal infiltration, tumor size, and lymph node CT value are crucial for evaluating the prognosis of patients with CRC.