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[Risk factors analysis of the early colorectal carcinoma after endoscopic non-curative resection: A retrospective clinical study of 56 cases].

医学 粘膜下层 淋巴血管侵犯 切除缘 结直肠癌 印戒细胞癌 上皮内瘤变 单变量分析 胃肠病学 腺癌 内科学 存活率 瘤芽 转移 外科 肿瘤科 癌症 多元分析 切除术 淋巴结转移 前列腺
作者
Ruigang Wang,Yueming Zhang,Lizhou Dou,Yong Liu,Shun He,Xiao Liu,Xinying Yu,Guiqi Wang
出处
期刊:PubMed 卷期号:20 (8): 923-927
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摘要

To explore the risk factors contributing to the progression-free survival rate of patients undergoing endoscopic non-curative resection.Clinicopathological data of patients with early colorectal carcinoma and intraepithelial neoplasia undergoing endoscopic resection in our department from January 2009 to January 2015 were collected. Associated factors affecting the progression-free survival rate of the early colorectal carcinoma after endoscopic non-curative resection were analyzed. Any of the following conditions was defined as endoscopic non-curative resection: (1) positive lateral or vertical cutting margin; (2) submucosa invasion depth ≥1 000 μm; (3) vascular or lymphatic invasion; (4) low differentiation, including signet ring cell carcinoma or mucinous adenocarcinoma; (5) high grade tumor budding.Clinicopathological data of 840 cases were collected. According to China's Endoscopic Screening, Diagnosis and Treatment Guidelines for Early Colorectal Cancer, 56(56/840, 6.7%) cases were defined as the non-curative resection, the metastasis or recurrence rate was 14.3%(8/56), 3-year progression-free survival rate was 85.7%(48/56), and 3-year overall survival rate was 94.6%(53/56). Univariate prognostic analysis showed that 3-year progression-free survival rate in low and moderate-high differentiation adenocarcinoma was 25.0% and 90.4%(χ2=6.711, P=0.010), in patients with submucosa invasion depth ≥2 000 μm and <2 000 μm was 75.0% and 93.8%(χ2=6.745, P=0.009), and in patients with and without vascular or lymphatic invasion was 60.0% and 88.2%(χ2=7.708, P=0.005), whose differences were all significant. Multivariate Cox regression analysis revealed that low differentiation adencarcinoma (P=0.015, HR=8.021, 95%CI: 1.499-42.921), invasion depth ≥2 000 μm (HR=6.823, 95%CI: 1.299-35.848) and vascular or lymphatic invasion (HR=18.143, 95%CI: 2.079-158.358) were independent risk factors for the progression-free survival rate of the early colorectal carcinoma after endoscopic non-curative resection.Pathology after endoscopic non-curative resection for early colorectal carcinoma indicates that low differentiation adenocarcinoma, submucosa invasion depth ≥2 000 μm and vascular or lymphatic invasion are independent risk factors of poor prognosis.

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