中国临床医学2025，Vol.32Issue(5)：726-733,8.DOI:10.12025/j.issn.1008-6358.2025.20250387
直肠癌根治术后异时性肿瘤性病变的影响因素
Influencing factors of metachronous tumor lesions after radical resection of rectal cancer
摘要
Abstract
Objective To explore risk factors for metachronous tumor lesions after radical resection of rectal cancer(RC).Methods A retrospective study was conducted on 757 RC patients who underwent RC radical surgery at the Sixth Affiliated Hospital,Sun Yat-sen University from October 2012 to June 2018.The patients were divided into early-onset RC group(EO-RC group,＜50 years old,n=228)and average-onset RC group(AO-RC group,≥50 years old,n=529)based on their age of diagnosis,and were followed up until March 2025.General information,initial colonoscopy,follow-up colonoscopy,and other relevant clinical information were collected from all patients.The risk of developing metachronous tumor lesions was compared between two groups using Kaplan Meier(K-M)risk function;univariate and multivariate Cox proportional hazards models were used to analyze the influencing factors of metachronous tumor lesions after RC radical surgery.Results The median follow-up time was 30(15,58)months.The K-M risk function showed that the risk of developing metachronous tumor lesions in the EO-RC group was significantly lower than that in the AO-RC group(P＜0.001).The results of the multivariate Cox proportional hazards model showed that the risk of metachronous tumor lesions after RC surgery in the EO-RC group was 50.8%of that in the AO-RC group(P＜0.001);PIK3CA mutation and synchronous advanced adenoma were independent risk factors for metachronous tumor lesions after RC surgery(HR=2.360,2.094;P=0.003,P＜0.001).Conclusions RC patients with advanced age,PIK3CA mutations,and synchronous advanced adenomas are prone to developing metachronous tumor lesions after surgery.Patients with EO-RC may not require intensified colonoscopy surveillance postoperatively.However,intensified surveillance strategies should be considered for RC patients harboring PIK3CA mutations or presenting with synchronous advanced adenomas.关键词
直肠癌/异时性腺瘤/异时性结直肠癌/结肠镜Key words
rectal cancer/metachronous adenoma/metachronous colorectal cancer/colonoscope分类
医药卫生引用本文复制引用
伍秋宁,陈永乐..直肠癌根治术后异时性肿瘤性病变的影响因素[J].中国临床医学,2025,32(5):726-733,8.基金项目
国家临床重点专科.Supported by National Key Clinical Discipline. （）
