T1.2期结直肠癌淋巴结转移风险因素分析：一项大样本研究

Analysis of Risk Factors for Lymph Node Metastasis in Stage T1.2 Colorectal Cancer: A Large Sample Study

摘要: 目的：探讨T1.2期结直肠癌淋巴结转移的风险因素，以期对临床治疗提供指导。方法：采取回顾性队列研究方法，收集2012年1月至2020年12月在空军军医大学第一附属医院西京医院消化外科接受结直肠癌根治术的T1.2期结直肠癌患者资料，共1249例，其中有淋巴结转移者289例，无淋巴结转移者960例，采用t检验、χ2检验比较各项指标，单因素分析有意义地纳入多因素Logistic回归进行分析，以P < 0.05为差异有统计学意义。结果：单因素分析显示术前白蛋白、胱抑素C、肿瘤标志物CA199、肿瘤T分期与淋巴结转移显著相关(P < 0.05)；经过多因素分析，术前白蛋白(OR = 1.044, 95% CI: 1.004~1.087, P = 0.031)、胱抑素C (OR = 0.466, 95% CI: 0.227~0.959, P = 0.038)、T分期(2期vs. 1期，OR = 2.290，95% CI：1.514~3.465，P < 0.001)是淋巴结转移的独立风险因素。结论：术前白蛋白、胱抑素C、肿瘤T分期是T1.2期结直肠癌淋巴结转移的独立风险因素，对诊断是否伴有淋巴结转移具备一定的辅助价值。

Abstract: Objective: To explore the risk factors of lymph node metastasis in T1.2 stage colorectal cancer, in order to provide guidance for clinical treatment. Methods: A retrospective cohort study method was adopted to collect data on patients with T1.2 stage colorectal cancer who underwent radical resection of colorectal cancer in Xijing Hospital, the First Affiliated Hospital of Air Force Military Medical University from January 2012 to December 2020, a total of 1249. Among them, there were 289 cases with lymph node metastasis and 960 cases without lymph node metastasis. The t-test and χ2 test were used to compare various indicators, and the univariate analysis was meaningfully included in the multivariate logistic regression analysis. The criterion for a statistically significant difference was P < 0.05. Results: Univariate analysis showed that preoperative albumin, cystatin C, tumor marker CA199, tumor T stage were significantly related to lymph node metastasis (P < 0.05); after multivariate analysis, preoperative albumin (OR = 1.044, 95% CI: 1.004~1.087, P = 0.031), cystatin C (OR = 0.466, 95% CI: 0.227~0.959, P = 0.038), T stage (Phase 2 vs. Phase 1, OR = 2.290, 95% CI: 1.514~3.465, P < 0.001) are independent risk factors for lymph node metastasis. Conclusion: Preoperative albumin, cystatin C, and tumor T staging are independent risk factors for lymph node metastasis in T1.2 stage colorectal cancer, and have certain auxiliary value in the diagnosis of lymph node metastasis.