目的分析结直肠癌患者术后早期和晚期复发转移与临床病理特征的关系。
方法回顾性分析2005年1月至2015年12月间海军军医大学附属长海医院结直肠癌手术后出现复发转移的391例患者，比较早期复发转移(<2年)和晚期复发转移(≥2年)患者的临床病理特征及预后的差异。
结果391例患者中246例患者出现早期复发转移(62.9%)，145例患者出现晚期复发转移(37.1%)。肝、全身转移和腹膜转移是早期复发转移的主要器官，肝、肺及全身转移是晚期复发转移的主要器官。肿瘤周径增大、淋巴结转移、血清CEA和CA19－9升高、无术后辅助治疗及微卫星稳定的患者更容易发生早期复发转移。早期复发转移患者的5年总体生存时间明显短于晚期复发转移患者。
结论结直肠癌患者的临床病理特征与术后复发转移密切相关；术后2年内是结直肠癌复发转移的重要危险期。
ObjectiveTo compare the characteristics of clinical pathology between patients with early recurrence and those with late recurrence of colorectal cancer.
MethodsClinicopathological data of 391 recurrence patients after surgery from Changhai Hospital were recruited between Jan 2005 and Dec 2015. The clinical and pathological characteristics of primary cancer in early recurrence group (less than 2 years after surgery) and late recurrence group (2 year or more after surgery) were compared.
Results246 patients had early recurrence (62.9%) and 145 had late recurrence (37.1%). Liver, systemic metastases and peritoneum were the main sites of distant recurrence in the early recurrence group, whereas liver, lung and systemic metastases were the most frequent sites of metastases in the late recurrence group. Patients with the increased tumor perimeter, lymph node metastasis, increased CEA and CA19-9, without postoperative adjuvant treatment and microsatellite stability are more likely to have early recurrence. 5-year overall survival rate for patients with early recurrence was significantly lower than those with late recurrence.
ConclusionsThis study showed that clinical and pathological factors are significantly associated with recurrence of colorectal cancer. Two years after surgery is an important period for the recurrence of colorectal cancer.
刘启志,郝立强,楼征,等. 结直肠癌术后早期和晚期复发转移与临床病理特征的关系[J]. 中华普通外科杂志,2019,34(8)：675-678.
DOI:10.3760/cma.j.issn.1007-631X.2019.08.008版权归中华医学会所有。
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除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。
刘启志：论文撰写；郝立强、楼征、刘连杰、洪永刚：收集资料；高显华：统计分析；张卫：核对资料
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