结直肠癌肝转移预后影响因素的分析  

Prognostic factors for colorectal cancer liver metastases

作　　者：柯恩明[1] 邹耀祥[1] 何宁[1] 张雪惠[1] 

机构地区：[1]厦门大学附属东南医院普通外科,福建漳州363000

出　　处：《中国普通外科杂志》2011年第10期1044-1046,共3页China Journal of General Surgery

摘　　要：目的探讨结直肠癌肝转移患者预后的相关影响因素。方法回顾性分析5年间收治的71例结直肠癌肝转移患者的临床病理资料。选择患者性别、年龄、肝转移部位、肝转移时间、转移灶数目、转移灶大小、原发肿瘤分化程度、有无淋巴转移、有无肝外转移以及肝转移病灶治疗方法等10个因素,用SPSS 17.0软件进行结直肠癌肝转移单因素分析和多因素Cox回归分析,并对有意义的相关因素进行交互作用分析。结果 71例结直肠癌肝转移患者生存时间为(16.5±5.3)个月,3年生存率为12.7%。单因素分析显示肝转移部位、转移灶数目、转移灶大小、肿瘤分化程度、有无淋巴转移、有无肝外转移以及肝转移病灶治疗方法等7个因素与预后有关,它们的组间差异均具有统计学意义(χ2=11.279,9.600,8.076,17.376,19.817,24.310,32.267;P<0.05)。Cox回归模型表明原发肿瘤分化程度(RR=1.671,95%CI 1.236～2.345,P=0.026),淋巴转移(RR=1.658,95%CI1.214～2.286,P=0.010),有无肝外转移(RR=2.586,95%CI 1.758～6.326,P=0.000)以及肝转移病灶治疗方法(RR=6.846,95%CI 3.624～13.032,P=0.000)与结直肠癌肝转移预后有密切关系。结论肿瘤分化程度、有无淋巴转移、有无肝外转移以及肝转移病灶治疗方法是结直肠癌肝转移预后的独立危险因素。Objective To investigate the prognostic factors of patients with liver metastases from colorectal cancer. Methods The clinicopathological data of 71 patients with liver metastasis from colorectal cancer admitted to our hospital during the past 5 years were retrospectively analyzed.Ten clinical factors of the patients that included gender,age,the size,location,and number of liver metastatic tumors,time interval between primary diagnosis and detection of liver metastasis,the differentiation level of primary tumor,presence of lymph node and extrahepatic metastasis,and the methods of treatment of liver metastases were selected to conduct univariate and multivariate Cox regression analysis.Interaction analyses were also performed between the significant related factors. Results Of the 71 patients,the average survival time was（16.5±5.3） months and the 3-year survival rate was 12.7%.The univariate analysis suggested that seven factors were related to prognosis,which included the size,location,and number of liver metastatic tumors,the differentiation level of primary tumor,presence or absence of lymph node and extrahepatic metastasis,and the methods of treatment of liver metastases,and they all had significant differences compared with their corresponding groups（χ2=11.279,9.600,8.076,17.376,19.817,24.310,32.267;P0.05）.Multivariate analysis revealed that the differentiation level of primary tumor（RR=1.671,95%CI 1.236-2.345,P=0.026）,lymph node metastasis（RR=1.658,95%CI 1.214-2.286,P=0.010）,extrahepatic metastasis（RR=2.586,95%CI 1.758-6.326,P=0.000） and the methods of treatment of liver metastasis（RR=6.846,95%CI 3.624-13.032,P=0.000） were closely related to the prognosis of colorectal liver metastases. Conclusions The differentiation level of primary tumor,lymph node and extrahepatic metastasis,and the methods of treatment of liver metastases were independent prognostic factors for colorectal liver metastases.

关 键 词：结直肠肿瘤 肝脏转移 预后 因素分析 统计学 

分 类 号：R735.3[医药卫生—肿瘤]