The Cox Regression Analysis Of Prognostic Factors Of 121 Cases Of Patients With Colon Carcinoma

Objective:To analyze and evaluate the important factors affecting the prognosis of patients with colon carcinoma and study the expression of p53 protein in human colon carcinoma and the relation to clinicopathology and prognosis.Methods:1. Data collection:Collected 159 cases of patients with colon carcinoma in The first affiliated hospital of Fujian Medical University from January 2003 to Decemer 2004.The expression of p53 protein in all of the conlon carcinoma tissues were detected by immunohistochemistry technique after operation. 121cases of the patients were followed-up by telephones, correspondence and outpatient following-up visits. The result of the 121 tissues of colon carcinoma were studied.2. Statistics methods:All data were analyzed by SPSS17.0.The statistics methods used include Chi-square test,Kaplan-Meier,log-rank test and Cox Regression.A P-value less than 0.05 was considered to be statistically significant.Results:1. For 121 cases,the 1-,3- and 5-year survival rates were 94.21%,73.55%,66.12%.2.For 121 cases,the patients with the positive expression of p53 protein in tissues of colon carcinoma were 63 cases,accounting for 52.07%.While the patients with the negative expression of p53 protein were 58 cases,accounting for 47.93%.3. There were significant differences between different invasive depth,regional lymph node metastasis,pathologic Borders classification and Dukes stage in the expression level of p53 protein(χ2=8.565,10.166, 9.689,12.308,P=0.014,0.001,0.021,0.002),while there were not significant differences between patient's gender, age, preoperative duration, tumor location, tumor diameter, general type, histological type, distant metastasis (P>0.05).4. The factors influencing prognosis of these patients with colon carcinoma were perioperative blood transfusion, histological type, lymph node metastasis, depth of bowel wall invasion, distant metastasis, Dukes stage, pathologic Borders classification, postoperative chemotherapy,curative surgery and the expression level of p53 protein through univariate analysis.While the independent risk factors influencing prognosis of these patients with colon carcinoma were pathologic Borders classification,Dukes stage, curative surgery, perioperative blood transfusion ,the expression level of p53 protein through multivariate analysis.5. The equation of risk factors for prognosis of patients with colon carcinoma was:h(t,x) = h0(t)exp(0.606X1+0.825X2+1.222X3+0.959X4+0.864X5). Prognostic index is equal to 0.606X1+0.825X2+1.222X3+0.959X4+0.864X5。(In this equation, X1 stands for pathologic Borders classification,X2 stands for Dukes stage, X3 stands for the type of resection, X4 stands for the perioperative blood transfusion, X5 stand for the expression levels of p53 protein in tissues of colon carcinoma.)Conclusions:1 The expression level of p53 protein in tissues of colon carcinoma closely correlated with invasive depth,lymph node metastasis, pathologic Borders classification,Dukes stage.2 The factors influencing prognosis of these patients with colon carcinoma were pathologic Borders classification,Dukes stage, curative surgery, perioperative blood transfusion ,the expression level of p53 protein.