阿司匹林对老年结直肠腺癌患者术后的预后影响

Effect of aspirin on prognosis of elderly patients with colorectal adenocarcinoma after operation

中文关键词: 老年  结直肠癌  阿司匹林  无病生存期

英文关键词: elderly  colorectal cancer  aspirin  disease-free survival

中文摘要:

      目的 分析老年结直肠腺癌(CRC)患者术后5 年的生存情况及阿司匹林(ASP)对其术后生存的影响.方法 回顾性分析2013 年1 月—2018 年5 月于上海交通大学医学院附属第九人民医院手术治疗的274 例老年CRC患者资料.根据患者确诊后有无连续服用ASP(100 mg/d)≥6 个月分为ASP组(n =60)和非ASP组(n =214).比较2 组的一般资料、手术资料及术前检测指标.分析患者术后5 年内的复发与生存情况.结果 与非ASP组比较,ASP组复发患者较少(36.92%vs 18.33%,P =0.007);ASP组3 年、4 年和5 年累积无病生存期(DFS)较长(P＜0.05).年龄增大、TNM分期Ⅲ期、肿瘤最大直径增大以及糖类抗原125 升高是老年CRC术后复发的危险因素,服用ASP是术后复发的保护因素(P＜0.05).年龄增大、TNM分期Ⅲ期和肿瘤最大直径增大是老年CRC术后DFS的危险因素.结论 ASP能一定程度减少老年CRC患者术后5 年的复发,延长患者的DFS.

英文摘要:

      Objective To analyze the 5?year survival of elderly patients with colorectal adenocarcinoma (CRC) after surgery and the effect of aspirin (ASP) on their postoperative survival. Methods The data of 274 elderly patients with CRC who underwent surgical treatment in Shanghai Ninth People??s Hospital Affiliated to Medical College of Shanghai Jiaotong Uni? versity from January 2013 to May 2018 were retrospectively analyzed. The patients were divided into ASP group (n =60) and non?ASP group (n =214) according to whether they had been continuously taking ASP (100 mg / d) ≥6 months after diagno? sis. The general data, surgical data and preoperative examination indexes of the two groups were compared. The recurrence and survival of patients within 5 years after operation were analyzed. Results Compared with the non?ASP group, the ASP group had fewer recurrent patients (36. 92% vs 18. 33% , P =0. 007), and the cumulative disease?free survival (DFS) at 3 years, 4 years, and 5 years in the ASP group was longer (P <0. 05). Advanced age, TNM stage III, increased maximal tumor diame? ter, and increased carbohydrate antigen 125 level were risk factors for postoperative recurrence in elderly CRC patients, while ASP intake was a protective factor for postoperative recurrence (P <0. 05). Advanced age, TNM stage III, and increased max? imal tumor diameter were risk factors for postoperative DFS in elderly CRC patients. Conclusion ASP can reduce the recur? rence of CRC in elderly patients to a certain extent within 5 years after surgery and prolong their DFS.