摘要
目的探讨与直肠间质瘤患者预后密切相关的临床病理危险因素,由此建立病理因素评分并分析其对直肠间质瘤的无瘤生存期的预测价值。方法收集2006年1月~2014年12月海军军医大学附属长海医院肛肠外科收治的均经完整手术切除,且术后病理确诊为直肠间质瘤的患者51例,按照危险度分级标准,肿瘤的危险度分为极低危度、低危度、中危度、高危度,将极低危度和低危度设为低危组,中危度和高危度设为高危组。收集其临床基本资料、病理数据、随访资料行回顾性分析,应用Cox单因素分析发现无瘤生存预后相关因素,Cox多因素分析发现独立的预后影响因素并利用赤池信息量准则(Akaike Information Criterion,AIC)查找最优模型,根据最优模型即临床病理因素评分评价直肠间质瘤患者的无瘤生存期。结果 Cox单因素分析结果提示,危险度分级高、术前中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)高是直肠间质瘤患者预后不良的影响因素,进一步行Cox多因素分析结果提示,危险度分级高、NLR高是其预后不良的独立影响因素。根据AIC拟合的最优模型-临床病理因素评分低危组的无瘤生存率显著高于高危组(P<0.05);高NLR组无癌生存率显著低于低NLR组(P<0.05)。结论危险度分级高、NLR高与直肠间质瘤患者无瘤生存期密切相关,临床病理因素评分可以有效评估直肠间质瘤的患者无瘤生存状况。
Objective To explore the clinicopathological risk factors closely related to the prognosis of patients with rectal stromal tumors, and to establish the pathological factor score and analyze its predictive value for the tumor-free survival of rectal stromal tumors. Methods From January 2006 to December 2014, 51 cases of rectal stromal tumor were collected from Changhai Hospital Affiliated to Naval Military Medical University. According to the risk classification standard, the risk of tumor was divided into extremely low risk, low risk, medium risk and high risk. The extremely low risk group and the low risk group were set as the low risk group, the medium risk group and the high risk group as the high risk group. The basic clinical data, pathological data and follow-up data were collected for retrospective analysis. Cox single factor analysis was used to find the prognostic factors of tumor free survival. Cox multivariate analysis found independent prognostic factors and used Akaike information criterion(AIC) to find the optimal model. The survival time of patients with rectal stromal tumor was evaluated according to the optimal model, i.e. clinicopathological factor score.Results The results of Cox single factor analysis indicated that the high risk grade and the high preoperative neutrophil to lymphocyte ratio(NLR) were the factors influencing the poor prognosis of patients with rectal stromal tumor. Further Cox multivariate analysis showed that high risk grade and high NLR were independent factors of poor prognosis. According to the optimal model fitted by AIC, the tumor free survival rate in the low risk group was significantly higher than that in the high risk group(P<0.05), and the cancer free survival rate in the high NLR group was significantly lower than that in the low NLR group(P<0.05). Conclusion The high risk grade and NLR are closely related to the tumor-free survival of patients with rectal stromal tumor. Clinicopathological factor score can effectively evaluate the tumorcfree survival of patients with rectal stromal tumor.
作者
康争春
鄂继福
于恩达
闫飞虎
马秀竹
张钧
KANG Zhengchun;E Jifu;YU Enda;YAN Feihu;MA Xiuzhu;ZHANG Jun(Department of Colorectal Surgery,Changhai Hospital,PLA Navy Medical Uneversity,Shanghai 200433,China;Department of Otolaryngology,Shidong Hospital of Yangpu,Shanghai 200433,China)
出处
《西部医学》
2020年第1期81-85,共5页
Medical Journal of West China
基金
国家自然科学基金(81802434)
军队科研基金(2017JZ19)
关键词
直肠间质瘤
无瘤生存期
危险度分级
病理因素评分
预测价值
Rectal stromal tumors
Tumor-free survival
Score
Clinicopathological factor score
Predictive value
