• 中國醫(yī)科大學附屬第四醫(yī)院胃腸外科（遼寧沈陽 110032）;

目的探討老年結腸癌患者臨床病理特點及預后的影響因素。方法回顧性分析405例≥60歲老年結腸癌患者（老年組）的臨床資料，進行預后分析并與同期收治的146例≤40歲的結腸癌患者（青年組）的臨床資料進行對比。結果2組患者在家族腫瘤史、合并疾病、術前腸梗阻及腫瘤分化程度方面的差異均有統計學（P＜0.05），老年組和青年組患者術后5年生存率分別為64.9%和56.8%（P＜0.05）。多因素回歸分析表明，合并其他疾病、術前血清CEA值、術前腸梗阻、腫瘤大體類型、淋巴結轉移、肝轉移及TNM分期是影響老年結腸癌患者術后生存的獨立因素。 結論老年結腸癌有著獨特的臨床病理特點，預后較好。影響老年結腸癌患者術后生存的獨立因素是合并其他疾病、術前血清CEA水平、并發(fā)腸梗阻、腫瘤大體類型、淋巴結轉移、肝轉移及TNM分期。

引用本文： 李曉霞,唐元新. 老年結腸癌患者預后影響因素分析. 中國普外基礎與臨床雜志, 2011, 18(7): 732-736. doi: 復制

1. Paraf F, Jothy S. Colorectal cancer before the age of 40: a casecontrol study [J]. Dis Colon Rectum, 2000, 43(9）: 12221226.
2. Mitry E, Benhamiche AM, Jouve JL, et al. Colorectal adenocarcinoma in patients under 45 years of age: comparison with older patients in a welldefined French population [J]. Dis Colon Rectum, 2001, 44(3): 380387.
3. Alici S, Aykan NF, Sakar B, et al. Colorectal cancer in young patients: characteristics and outcome [J]. Tohoku J Exp Med， 2003， 199(2): 8593.
4. Chan KK, Dassanayake B, Deen R, et al. Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and longterm: analysis of survival and prognostic markers [J]. World J Surg Oncol， 2010， 8: 8292.
5. 韋達, 許發(fā)培. 青年和高齡大腸癌的比較性研究 [J]. 腫瘤防治雜志, 2005, 12（24): 18781880.
6. 蔡善榮, 鄭樹, 張?zhí)K展. 不同年齡組大腸癌預后多因素分析的比較 [J]. 中華腫瘤雜志, 2005, 27（8）： 483485.
7. 高強, 竇倩慧, 方超, 等. 影響結腸癌患者術后并發(fā)癥的多因素分析 [J]. 中國普外基礎與臨床雜志， 2011, 18（2）: 159163.
8. 盧震海, 萬德森, 王國強, 等. 1126例結腸癌患者的臨床病理特征及預后分析 [J]. 廣東醫(yī)學雜志, 2007, 28（6）: 908910.
9. Compton C, FenoglioPreiser CM, Pettigrew N, et al. American Joint Committee on Cancer Prognostic Factors Consensus Conference: Colorectal Working Group [J]. Cancer, 2000， 88(7): 17391757.
10. Ratto C, Sofo L, Ippoliti M, et al. Prognostic factor in colorectal cancer.Literature review for clinical application [J]. Dis Colon Rectum, 1998, 41（8）: 10331049.
11. Korenaga D, Ueo H, Mochida K, et al. Prognostic factors in Japanese patients with colorectal cancer: the significance of large bowel obstructionunivariate and multivariate analyses [J]. J Surg Oncol, 1991, 47(3): 188192.
12. Park YJ, Park KJ, Park JG, et al. Prognostic factors in 2230 Korean colorectal cancer patients: analysis of consecutively operated cases [J]. World J Surg， 1999， 23(7): 721726.
13. 汪建平, 楊祖立, 王磊, 等. 結直腸癌臨床病理特征與預后的多因素回歸分析 [J]. 中華腫瘤雜志， 2003, 25（1）: 5961.
14. Derwinger K, Gustavsson B. A study of lymph node ratio in stage IV colorectal cancer [J]. World J Surg Oncol, 2008, 6: 127132.
15. Derwinger K, Carlsson G, Gustavsson B, et al. A study of lymph node ratio as a prognostic marker in colon cancer [J]. Eur J Surg Oncol， 2008， 34(7): 771775.
16. Chin CC, Wang JY, Yeh CY, et al. Metastatic lymph node ratio is a more precise predictor of prognosis than number of lymph node metastases in stage Ⅲ colon cancer [J]. Int J Colorectal Dis， 2009， 24(11): 12971302.
17. Chua TC, Yan TD, Ng KM, et al. Significance of lymph node metastasis in patients with colorectal cancer peritoneal carcinomatosis [J]. World J Surg, 2009, 33（7): 14881494.
18. Sadahiro S, Suzuki T, Maeda Y, et al. Prognostic factors in patients with synchronous peritoneal carcinomatosis (PC) caused by a primary cancer of the colon [J]. J Gastrointest Surg, 2009, 13(9): 15931598.
19. Pestieau SR, Sugarbaker PH. Treatment of primary colon cancer with peritoneal carcinomatosis: comparison of concomitant vs. delayed management [J]. Dis Colon Rectum, 2000， 43(10): 13411346.
20. Merkel S, Wein A, Gunther K, et al. Highrisk group of patients with stage Ⅱ colon carcinoma [J]. Cancer, 2001, 92（6）: 14351443.
21. Gryfe R, Kim H, Hsieh ET, et al. Tumor microsatellite instability and clinical outcome in young patients with colorectal cancer [J]. N Engl J Med, 2000, 342（2）: 6977.
22. Ribic CM, Sargent DJ, Moore MJ, et al. Tumor microsatelliteinstability status as a predictor of benefit from fluorouracilbased adjuvant chemotherapy for colon cancer [J]. N Engl J Med, 2003, 349(3): 247257.
23. Elsaleh H, Iacopetta B. Microsatellite instability is a predictive marker for survival benefit from adjuvant chemotherapy in a populationbased series of stage Ⅲ colorectal carcinoma [J]. Clin Colorectal Cancer, 2001， 1(2): 104109.
24. 呂東昊, 汪曉東, 陽川華, 等. 結直腸腫瘤多學科協作診治模式的數據庫初期建設現狀 [J]. 中國普外基礎與臨床雜志, 2007, 14(6): 713715.
25. 汪曉東, 馮碩, 游小林, 等. 結直腸腫瘤多學科協作診治模式下的隨訪體系建設 [J]. 中國普外基礎與臨床雜志, 2007, 14(6): 709712.
  1. 1. Paraf F, Jothy S. Colorectal cancer before the age of 40: a casecontrol study [J]. Dis Colon Rectum, 2000, 43(9）: 12221226.
  2. 2. Mitry E, Benhamiche AM, Jouve JL, et al. Colorectal adenocarcinoma in patients under 45 years of age: comparison with older patients in a welldefined French population [J]. Dis Colon Rectum, 2001, 44(3): 380387.
  3. 3. Alici S, Aykan NF, Sakar B, et al. Colorectal cancer in young patients: characteristics and outcome [J]. Tohoku J Exp Med， 2003， 199(2): 8593.
  4. 4. Chan KK, Dassanayake B, Deen R, et al. Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and longterm: analysis of survival and prognostic markers [J]. World J Surg Oncol， 2010， 8: 8292.
  5. 5. 韋達, 許發(fā)培. 青年和高齡大腸癌的比較性研究 [J]. 腫瘤防治雜志, 2005, 12（24): 18781880.
  6. 6. 蔡善榮, 鄭樹, 張?zhí)K展. 不同年齡組大腸癌預后多因素分析的比較 [J]. 中華腫瘤雜志, 2005, 27（8）： 483485.
  7. 7. 高強, 竇倩慧, 方超, 等. 影響結腸癌患者術后并發(fā)癥的多因素分析 [J]. 中國普外基礎與臨床雜志， 2011, 18（2）: 159163.
  8. 8. 盧震海, 萬德森, 王國強, 等. 1126例結腸癌患者的臨床病理特征及預后分析 [J]. 廣東醫(yī)學雜志, 2007, 28（6）: 908910.
  9. 9. Compton C, FenoglioPreiser CM, Pettigrew N, et al. American Joint Committee on Cancer Prognostic Factors Consensus Conference: Colorectal Working Group [J]. Cancer, 2000， 88(7): 17391757.
  10. 10. Ratto C, Sofo L, Ippoliti M, et al. Prognostic factor in colorectal cancer.Literature review for clinical application [J]. Dis Colon Rectum, 1998, 41（8）: 10331049.
  11. 11. Korenaga D, Ueo H, Mochida K, et al. Prognostic factors in Japanese patients with colorectal cancer: the significance of large bowel obstructionunivariate and multivariate analyses [J]. J Surg Oncol, 1991, 47(3): 188192.
  12. 12. Park YJ, Park KJ, Park JG, et al. Prognostic factors in 2230 Korean colorectal cancer patients: analysis of consecutively operated cases [J]. World J Surg， 1999， 23(7): 721726.
  13. 13. 汪建平, 楊祖立, 王磊, 等. 結直腸癌臨床病理特征與預后的多因素回歸分析 [J]. 中華腫瘤雜志， 2003, 25（1）: 5961.
  14. 14. Derwinger K, Gustavsson B. A study of lymph node ratio in stage IV colorectal cancer [J]. World J Surg Oncol, 2008, 6: 127132.
  15. 15. Derwinger K, Carlsson G, Gustavsson B, et al. A study of lymph node ratio as a prognostic marker in colon cancer [J]. Eur J Surg Oncol， 2008， 34(7): 771775.
  16. 16. Chin CC, Wang JY, Yeh CY, et al. Metastatic lymph node ratio is a more precise predictor of prognosis than number of lymph node metastases in stage Ⅲ colon cancer [J]. Int J Colorectal Dis， 2009， 24(11): 12971302.
  17. 17. Chua TC, Yan TD, Ng KM, et al. Significance of lymph node metastasis in patients with colorectal cancer peritoneal carcinomatosis [J]. World J Surg, 2009, 33（7): 14881494.
  18. 18. Sadahiro S, Suzuki T, Maeda Y, et al. Prognostic factors in patients with synchronous peritoneal carcinomatosis (PC) caused by a primary cancer of the colon [J]. J Gastrointest Surg, 2009, 13(9): 15931598.
  19. 19. Pestieau SR, Sugarbaker PH. Treatment of primary colon cancer with peritoneal carcinomatosis: comparison of concomitant vs. delayed management [J]. Dis Colon Rectum, 2000， 43(10): 13411346.
  20. 20. Merkel S, Wein A, Gunther K, et al. Highrisk group of patients with stage Ⅱ colon carcinoma [J]. Cancer, 2001, 92（6）: 14351443.
  21. 21. Gryfe R, Kim H, Hsieh ET, et al. Tumor microsatellite instability and clinical outcome in young patients with colorectal cancer [J]. N Engl J Med, 2000, 342（2）: 6977.
  22. 22. Ribic CM, Sargent DJ, Moore MJ, et al. Tumor microsatelliteinstability status as a predictor of benefit from fluorouracilbased adjuvant chemotherapy for colon cancer [J]. N Engl J Med, 2003, 349(3): 247257.
  23. 23. Elsaleh H, Iacopetta B. Microsatellite instability is a predictive marker for survival benefit from adjuvant chemotherapy in a populationbased series of stage Ⅲ colorectal carcinoma [J]. Clin Colorectal Cancer, 2001， 1(2): 104109.
  24. 24. 呂東昊, 汪曉東, 陽川華, 等. 結直腸腫瘤多學科協作診治模式的數據庫初期建設現狀 [J]. 中國普外基礎與臨床雜志, 2007, 14(6): 713715.
  25. 25. 汪曉東, 馮碩, 游小林, 等. 結直腸腫瘤多學科協作診治模式下的隨訪體系建設 [J]. 中國普外基礎與臨床雜志, 2007, 14(6): 709712.