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目的探讨可能导致直肠癌术后局部复发的临床病理因素。方法应用单因素和多因素分析方法,回顾性分析2004年1月至2011年4月期间我院收治的368例直肠癌患者完整临床及病理资料。结果局部复发73例,占同期直肠癌(368例)的19.84%。单因素分析结果显示,直肠癌患者的性别、肿瘤距肛缘距离、肿瘤周径、TNM分期、组织学类型、脉管浸润、肿瘤穿孔、吻合口漏及放化疗与术后局部复发有关(P<0.05),而与年龄、病程、大体类型、肿瘤直径及手术方式无关(P>0.05)。进一步多因素分析结果显示,肿瘤距肛缘距离、肿瘤周径、TNM分期、组织学类型、脉管浸润、肿瘤穿孔及放化疗是术后局部复发转移的危险因素(P<0.05)。结论直肠癌术后局部复发与多种因素有关,脉管浸润是最重要的危险因素。
Objective To investigate the clinicopathological factors that may lead to local recurrence of rectal cancer. Methods The univariate and multivariate analysis methods were used to retrospectively analyze the complete clinical and pathological data of 368 rectal cancer patients admitted to our hospital from January 2004 to April 2011. The results of local recurrence in 73 cases, accounting for 19.84% of the same period of rectal cancer (368 cases). The results of univariate analysis showed that the gender, the distance from the anal verge, tumor circumference, TNM stage, histological type, vascular invasion, tumor perforation, anastomotic leakage and chemoradiation and postoperative local recurrence in patients with rectal cancer (P <0.05), but not related to age, duration of disease, gross type, tumor diameter and surgical method (P> 0.05). Further multivariate analysis showed that the distance from the anal verge, tumor circumference, TNM stage, histological type, vascular invasion, tumor perforation and radiochemotherapy were the risk factors of local recurrence and metastasis (P <0.05). Conclusion Local recurrence of rectal cancer with a variety of factors, vascular invasion is the most important risk factor.