结直肠癌术后肝转移预后影响因素的研究  

Influence factors for prognosis of liver metastasis after colorectal cancer operation

作　　者：贾昀豪 余进松 李忠[1] 李渊[1] 刘元直[1] 丁波[1] JIA Yunhao;YU Jinsong;LI Zhong;LI Yuan;LIU Yuanzhi;DING Bo(Department of General surgery,the First People's Hospital of Nanyang,Nanyang,Henan 473000,China)

机构地区：[1]河南省南阳市第一人民医院普外三科,河南南阳473000

出　　处：《中国医学工程》2020年第4期11-13,共3页China Medical Engineering

摘　　要：目的探讨影响结直肠癌术后肝转移患者预后的因素。方法回顾性分析该院2014年3月至2017年3月收治的106例结直肠癌术后肝转移患者的临床资料,并定期对患者进行随访,计算其生存率、中位生存时间(MST)。采用Logrank检验及Cox比例风险模型对结直肠癌术后肝转移患者生存的影响因素进行单因素、多因素分析。结果 106例结直肠癌术后肝转移患者1和2年生存率分别为63.3%、41.4%,MST为20.6个月。单因素分析结果显示,病理类型、分化程度、化疗、介入治疗、癌胚抗原(CEA)与结直肠癌术后肝转移患者的预后相关;多因素分析结果显示,病理类型(HR=0.57,95%CI:0.338~0.915, P=0.018)、肝转移灶数目(HR=0.387, 95%CI:0.254~0.862, P=0.005)是影响结直肠癌术后肝转移患者预后的独立危险因素,化疗(HR=2.216, 95%CI:1.427~3.638, P=0.001)是结直肠癌术后肝转移患者的独立保护因素。结论结直肠癌术后肝转移患者预后较差,化疗可有效提高患者的生存率。【Objective】To investigate the prognostic factors in patients with liver metastases after colorectal cancer surgery.【Methods】The clinical data of 106 patients with postoperative liver metastases from colorectal cancer admitted to our hospital from March 2014 to March 2017 were retrospectively analyzed. The patients were followed up regularly to calculate the survival rate and median survival time(MST). The factors affecting the survival of patients with liver metastases from colorectal cancer were analyzed by Log-rank test and Cox proportional hazard model by single factor and multi-factor analysis.【Results】The 1-and 2-year survival rates of 106 patients with liver metastases after colorectal cancer were 63.3% and 41.4%, respectively, and the MST was 20.6 months. Univariate analysis showed that pathological type, degree of differentiation, chemotherapy, interventional therapy,CEA and prognosis of patients with postoperative liver metastases from colorectal cancer were correlated;multivariate analysis showed that pathological type(HR=0.57, 95%CI: 0.338~0.915, P=0.018), the number of liver metastases(HR=0.387, 95%CI: 0.254~0.862, P=0.005) were independent risk factors for the prognosis of patients with liver metastases after colorectal cancer surgery,chemotherapy(HR=2.216, 95%CI: 1.427~3.638, P=0.001) was an independent protective factor for patients with postoperative liver metastases from colorectal cancer.【Conclusion】The prognosis of patients with liver metastases after colorectal cancer is poor, and chemotherapy can effectively improve the productivity of patients.

关 键 词：结直肠癌 肝转移 生存率 预后 

分 类 号：R735.3[医药卫生—肿瘤]