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外科研究与新技术（中英文）

外科研究与新技术（中英文） ›› 2026, Vol. 15 ›› Issue (3): 221-225.doi: 10.3969/j.issn.2095-378X.2026.03.005

• 论著 • 上一篇    下一篇

左、右半结肠癌根治术患者临床病理特征、死亡风险及复发模式比较

黑静雅1, 白晓辉2   

  1. 1.宁夏医科大学总医院病理科,宁夏 银川 750001;
    2.宁夏回族自治区第三人民医院急诊科,宁夏 银川 750027
  • 收稿日期:2025-12-10 出版日期:2026-09-28 发布日期:2026-09-30
  • 作者简介:黑静雅（1978—）,女,副主任医师,从事临床病理诊断工作;电子信箱：jingya1978@163.com

Comparison of clinicopathological characteristics, risk of death, and recurrence patterns in patients undergoing radical resection for left-sided and right-sided colon cancer

HEI Jingya1, BAI Xiaohui2   

  1. 1. Pathology Department, General Hospital of Ningxia Medical University, Yinchuan 750001, Ningxia, China;
    2. Emergency Department, The Third People’s Hospital of Ningxia, Yinchuan 750027, Ningxia, China
  • Received:2025-12-10 Online:2026-09-28 Published:2026-09-30

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摘要： 目的 探讨左、右半结肠癌患者在临床病理特征、相对死亡风险及根治术首次复发转移模式方面的差异。方法 回顾性分析2018年6月—2021年6月于医院接受根治性手术治疗的90例结肠癌患者的临床资料。依据肿瘤部位分为右半结肠癌组（RCC,n=45）和左半结肠癌组（LCC,n=45）。比较两组在基本临床资料、病理特征、死亡风险及复发转移部位等方面的差异。统计方法采用t检验、卡方检验及Cox比例风险模型,随访截至2024年6月。结果 两组在性别、年龄、肿瘤标志物[包括癌胚抗原（CEA）、糖类抗原（CA）19-9]、手术与化疗比例等方面差异无统计学意义（均P>0.05）。RCC组肿瘤直径（P=0.004）及淋巴结检出数（P=0.001）显著高于LCC组。多因素Cox回归分析显示,RCC组CEA升高、肿瘤分期Ⅲ-Ⅳ期、肿瘤体积大、存在脉管瘤栓和癌结节为独立不良预后因素（P<0.05）,而接受根治术显著降低死亡风险（P<0.05）。RCC组腹腔种植转移趋势较高,LCC组吻合口复发相对更常见,但差异均无统计学意义（P>0.05）。结论 左、右半结肠癌在肿瘤大小、淋巴结清扫数量和预后风险等方面存在显著差异。右半结肠癌患者具有更大的肿瘤负荷和更高的死亡风险,提示需加强术前评估与术后管理。结肠癌的精准治疗与随访策略应综合考虑肿瘤侧别、生物学行为与预后风险因素。

关键词: 结肠癌, 右半结肠癌, 左半结肠癌, 临床病理特征, 死亡风险, 复发转移模式, Cox回归分析

Abstract: Objective To investigate the differences in clinicopathological characteristics, relative mortality risk, and patterns of first recurrence/metastasis after radical resection between right-sided colon cancer （RCC） and left-sided colon cancer （LCC）. Methods A retrospective analysis was conducted on 90 patients with pathologically confirmed colon cancer who underwent radical resection at our hospital between June 2018 and June 2021. Based on tumor location, patients were divided into the RCC group （n=45） and the LCC group （n=45）. Clinical features, pathological parameters, risk of death, and sites of recurrence or metastasis were compared. Statistical analysis included t-tests, chi-square tests, and Cox proportional hazards modeling. Follow-up continued until June 2024. Results There were no significant differences between the two groups in age, sex, tumor markers[carcinoembryonic antigen （CEA） and carbohydrate antigen （CA） 19-9], or rates of curative surgery and adjuvant chemotherapy （P>0.05）. RCC patients had significantly larger tumor diameters （P=0.004） and higher numbers of lymph nodes retrieved （P=0.001） than LCC patients. Multivariate Cox proportional hazards modeling analysis revealed that elevated CEA, tumor stage Ⅲ-Ⅳ, larger tumor size, lymphovascular invasion, and presence of tumor nodules were independent predictors of poor prognosis （P<0.05）, whereas radical resection was associated with improved survival （P<0.05）. Although differences in first recurrence/metastasis sites were not statistically significant （P>0.05）, RCC showed a higher tendency toward peritoneal dissemination, while anastomotic recurrence was more frequent in LCC. Conclusion RCC and LCC demonstrate significant differences in tumor size, lymph node dissection number, and prognostic risk. RCC is associated with bigger tumor burden and poorer survival outcomes, highlighting the need for enhanced preoperative assessment and postoperative surveillance. Tumor laterality, biological behavior, and risk factors for prognosis should be considered in the development of precision treatment and follow-up strategies for colon cancer patients.

Key words: Colon cancer, Right-sided colon cancer, Left-sided colon cancer, Clinicopathological features, Mortality risk, Recurrence and metastasis patterns, Cox regression analysis

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