【摘要】 目的 探討淋巴結轉移數目對行手術治療的結腸癌患者預后的影響。 方法 回顧性分析2005年1月-2007年12月符合篩選標準的148例行手術治療的結腸癌患者的臨床和隨訪資料，按照淋巴結轉移數目進行分組：N0組（0枚）91例、N1組（1～3枚）41例、N2組（≥4枚）16例，采用Kaplan-Meier法進行生存分析，用Log-rank比較3組術后3年生存率，等級資料采用秩和檢驗，用χ2檢驗進行兩兩比較術后3年局部復發率、遠處轉移率和死亡率情況。 結果 N0、N1、N2 3組的術后3年生存率分別為88.1%、71.4%、61.1%，3組生存率差異有統計學意義（P=0.003）；N0、N1、N2 3組的總體局部復發率、遠處轉移率和死亡率的差異有統計學意義（P=0.006，0.001，0.005）。 結論 淋巴結轉移數目是結腸癌患者術后3年生存情況的危險因素，無淋巴結轉移的患者術后3年生存情況明顯比有淋巴結轉移者好。
【Abstract】 Objective To discuss the impact of the number of lymph node metastasis on the prognosis of patients with colon cancer after surgical operation. Methods The clinical data of 148 patients with colon cancer who underwent surgical operation between January 2005 and December 2007 were analyzed retrospectively. According to the number of lymph node metastasis, the patients were divided into three groups, group N0(the number of lymph metastasis equals to 0), group N1(the number of lymph node metastasis ranges from 1 to 3) and group N2 (the number of lymph node metastasis was equal or greater than 4). And we chose Kaplan-Meier to analyze patients′ survival and Log-rank test was used to compare the 3-year survival index; rank sum test was used to analyze the level data, and then chi-square test was chosen to compare local recurrence rate, metastasis rate and mortality among the three groups. Results The indexes of the 3-year survival in group N0 (91 cases), group N1 (41 cases) and group N2(16 cases) wre 88.1%, 1.4%, and 61.1%, respectively. The differences were significant (P=0.003). Besides, the differences between group N0 and N1, N0 and N2 were both significant (P=0.012,0.002); the differences between group N1 and N2 was not significant (P=0.344). The differences among three groups in local recurrence rate, metastasis rate and mortality were all significant(P=0.006, 0.001, 0.005); the differences between group N0 and N1 in local recurrence rate, metastasis rate and mortality were significant (P=0.008, 0.000, 0.012); the differences between group N0 and N2 in local recurrence rate, metastasis rate and mortality were significant (P=0.021, 0.047, 0.010), while the differences between group N1 and N2 in local recurrence rate, metastasis rate and mortality were not significant (P=1.000,0.585,0.523). Conclusion The number of lymph node metastasis is a dangerous factor to the 3-year survival in patients with colon cancer after operation, and the prongnosis of the 3-year survival in patients without lymph node metastasis is better than that in patients′ with lymph node metastasis.
引用本文： 楊小玲,李雪,王正東,黃明君,汪曉東,李卡. 淋巴結轉移數目對結腸癌患者預后的影響. 華西醫學, 2011, 26(11): 1672-1675. doi: 復制