摘要
目的探讨肿瘤神经侵犯(PNI)在Ⅱ期直肠癌中预后指导意义。方法调取194例行直肠癌根治术的Ⅱ期直肠癌患者病理HE染色切片,重新读片,根据HE染色判断PNI情况,并分析其在临床5年无瘤生存率及总生存率的意义。结果 PNI 36(18.5%)例,PNI仅与肿瘤分化程度(P<0.01)及脉管浸润(P=0.02)相关,与年龄、性别、肿瘤大小、肿瘤部位、浸润深度、活检淋巴结数无关。单因素分析显示,浸润深度(P=0.149)、活检淋巴结数(P=0.052)、脉管浸润(P=0.013)、PNI(P<0.001)是5年无瘤生存率的危险预后因素,年龄(P=0.029)、性别(P=0.063)、肿瘤部位(P=0.063)、活检淋巴结数(P=0.028)是5年总生存率的危险预后因素;多因素分析发现活检淋巴结数(P=0.001)是5年总生存率的独立预后因素,PNI(P=0.001)是5年无瘤生存率的独立预后因素。结论 PNI是Ⅱ期直肠癌的无瘤生存时间独立预后因素,PNI可作为Ⅱ期直肠癌预后判断的重要参考。
Objective To investigate the prognostic value of perineural invasion （ PNI ） in patients with stage II rectal carcinoma. Methods HE stained tissue sections from 194 patients who underwent radical resection of stage II rectal cancer were accessed and re-readed. The chi-square test was taken on PNI according to HE stain, and multivariable COX analysis was applied to analyse disease-free survival and overall survial. Results PNI was identified in 36 patients （ 18.5 % ）, only related with differentiation （ P 〈 0. 01 ） and vascular invasion （ P = 0. 02 ） in the clinical and pathological characteristics, while did not relate with age, gender, depth of tumor invasion, tumor diameter. In the univariate analysis, factors associated with poorer disease free survival were depth of tumor invasion （P = 0. 149 ）, number of lymph nodes harvested （ P = 0. 052 ）, vascular invasion （ P = 0. 013 ）, perineural invasion （ P 〈 0. 001 ）. Age （P = 0. 029 ） , gender （ P = 0. 063 ） , location （ P = 0. 063 ） , number of lymph nodes harvested （ P = 0. 028） were related with worse over-all survival. Multivariate analysis revealed that PNI （ P = 0. 001 ） was the only independent prognostic factor for disease-free survival in 5 years, while the number of lymph nodes harvested （ P = 0. 001 ） was the only independent prognostic factor for over-all survival. Conclusion Perineural invasion is the only independent prognostic factor for disease free survival which can be treated as an important reference in the prognosis of stage II rectal carcinoma.
出处
《安徽医科大学学报》
CAS
北大核心
2012年第9期1095-1098,共4页
Acta Universitatis Medicinalis Anhui
关键词
直肠癌
预后
肿瘤浸润
神经侵犯
rectal carcinoma
prognostic
trmor invasion
perineural invasion
