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直肠癌病理和分子生物特征与预后的多因素分析
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- Author:
- No author available
- Journal Title:
- WORLD CHINESE JOURNAL OF DIGESTOLOGY
- Issue:
- 13
- DOI:
- 10.3969/j.issn.1009-3079.2005.13.028
- Key Word:
- No keyword available
Abstract： 目的:探讨直肠癌临床病理特征和生物学因素与预后的关系.方法:143例直肠癌患者,青年组31例,中年组60例,老年组52例,中高分化腺癌101例,其他42例,低于C期的67例,淋巴结转移31例,应用EnVision法分析切片P16ink4a、P53、PCNA和PKC-α的表达,单因素和多因素分析其对预后的影响.结果:各年龄组5 a生存率分别为56.5%,61.4%和59.4%.单因素分析,预后与病理类型(χ2=18.994,P=0.002)、淋巴结转移情况(χ2=13.311,P=0.021)、临床病理分期(χ2=17.075,P=0.004)及年龄(χ2=11.249,P=0.047)均有显著相关;与P16int4a的表达缺失(χ2=15.179,P=0.01)、突变型P53的过度表达(χ2=28.185,P＜0.001)显著相关.COX模型分析显示,临床病理类型、病理分期、P16ink4a的表达缺失、突变型P53的过度表达是独立预后因素,P值分别为0.029,0.028,＜0.001和＜0.001,风险比分别为1.982,2.049,0.219和4.175.结论:直肠癌病理类型、病理分期和P16ink4a、P53是重要的预后指标,可以指导直肠癌患者术后个体化治疗.
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