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頁籤選單縮合
題名 | The Relationship between the Presentation of Hematochezia and Colon Cancer=血便的表現與大腸癌之間的關係 |
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作者 | 黃政義; 靳志堅; 謝孟樵; 郭益宏; 黃文詩; 葉重宏; 陳進勛; 唐瑞平; 王正儀; Huang, Cheng-yi; Chin, Chih-chien; Hsieh, Meng-chiao; Kuo, Yi-hung; Huang, Wen-shih; Yeh, Chung-hung; Chen, Jinn-shiun; Tang, Reiping; Wang, Jeng-yi; |
期刊 | 中華民國大腸直腸外科醫學會雜誌 |
出版日期 | 20121200 |
卷期 | 23:4 2012.12[民101.12] |
頁次 | 頁160-167 |
分類號 | 416.245 |
語文 | eng |
關鍵詞 | 結腸癌; 血便; 貧血; Colon cancer; Hematochezia; Anemia; |
中文摘要 | 目的 血便是大腸癌最常見症狀之一。本研究的目的是藉由分析血便在非轉移大腸癌患者的表現,探討是否能提供我們更多的臨床意義與訊息。方法 在這個回溯性的研究中,我們收集了3641例非轉移的大腸癌病患。透過邏輯性迴歸分析探討血便與大腸癌其他因子及手術後之結果的關係。使用比例風險迴歸模式來分析血便與大腸癌患者長期存活率的關係。結果 經由邏輯式迴歸分析發現血便與腫瘤位置(左側比右側:風險比3.19;p<0.001),腫瘤型態(息肉狀比非息肉狀:風險比1.33;p=0.005),全腸圍侵犯 (非整圈侵犯比整圈侵犯:風險比1.48;p<0.001)等有相關聯性。對照有血便的病患來說,沒有表現血便的病患會有更高比例的低血蛋白血症(20.4% 比14.5%;p<0.001)、明顯的貧血(27.0%比23.6%;p = 0.020)及異常的癌胚抗原指數(37.1% 比33.6%;p=0.028)。血便表現並無顯著影響術後的併發症及死亡率。病患有無血便表現的5 年存活率各為77.9% 和73%(p < 0.004),5年無復發存活率各為74.7%和70.4%(p=0.015)。但是,在多變數分析中,血便的表現並不是影響存活率和無復發存活率的預後因子。結論 血便在大腸癌病患並不只是一個警示的症狀跟表徵,它跟腫瘤位置、腫瘤型態、全腸圍侵犯等有相關聯性;另外,它並不是非轉移大腸癌的長期預後因子。 |
英文摘要 | Objective. Hematochezia is one of the most common symptoms of colon cancer. This study investigated whether the presence of hematochezia could indicate additional clinical information on non-metastatic colon cancer.Methods. In this retrospective study, we enrolled 3641 consecutive nonmetastatic colon cancer patients. Logistic regression analysis was performed to determine the correlation between hematochezia and other characteristics and postoperative outcome of colon cancer. The Cox regression model was used to determine the correlation between hematochezia and long-term survival in colon cancer patients.Results. Logistic regression analysis showed that hematochezia was significantly associated with tumor location (left vs. right: odds ratio [OR]=3.19; p<0.001), tumor morphology (polypoid vs. non-polypoid: OR=1.33; p=0.005), and circumferential involvement (no vs. yes: OR=1.48;p<0.001). Compared to patients with hematochezia, those without hematochezia were more likely to have hypoalbuminemia (20.4% vs. 14.5%; p<0.001), obvious anemia (27.0% vs. 23.6%; p=0.020), and abnormal carcinoembryonic antigen levels (37.1% vs. 33.6%; p=0.028). Postoperative morbidity and mortality were not significantly correlated with hematochezia. The 5-year overall survival rates of patients with and without hematochezia were 77.9% and 73.0%, respectively (p<0.004), and the 5-year relapse-free survival rates were 74.7% and 70.4%, respectively (p=0.015). However, multivariate analysis showed that hematochezia was not a significant prognostic factor of overall survival and relapse-free survival. Conclusion. Hematochezia in colon cancer patients is not only an alert symptom, but is also correlated with tumor location, tumor morphology, and circumferential involvement. However, it is not a prognostic factor for poor long-term outcome in non-metastatic colon cancer patients. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。