结合影像特征对结直肠癌同时性肝转移同期及二期切除术患者的预后分析  

Based on imaging features to analyze the prognosis of patients with synchronous liver metastasis of colorectal cancer underwent primary or secondary resection

作　　者：李涵笑 刘再毅[2] 黄燕琪[2] 黎娇 朱超 梁长虹 LI Han-xiao;LIU Zai-yi;HUANG Yan-qi(School of Medicine,South China University of Technology,Guangzhou 510006,China)

机构地区：[1]华南理工大学医学院,广州510006 [2]广东省人民医院(广东省医学科学院)放射科,广州510080

出　　处：《放射学实践》2021年第5期606-610,共5页Radiologic Practice

基　　金：国家重点研发计划(2017YFC1309100、102、104);国家杰出青年科学基金(81925023)。

摘　　要：目的:探讨与结直肠癌同时性肝转移(sCRLM)患者术后生存时间相关的影像学特征及临床危险因素,进而指导临床治疗决策的制定。方法:通过纳入69例采用一期或二期切除的结直肠癌同时性肝转移患者,提取临床及影像相关因素并对患者进行随访,获得生存时间进行分析。结果:最终有57例患者获得了有效随访信息。一期与二期切除两种手术方式在生存时间上差异无统计学意义(P>0.05);多因素COX回归分析发现临床CRS评分、转移灶内存在坏死以及原发灶突破浆膜是预后的独立预测因子(P<0.05)。结论:一期或二期手术切除患者的生存时间差异无统计学意义,临床CRS评分、转移灶内存在坏死及原发肿瘤突破浆膜可作为预后预测因子。Objective:The aim of the study was to identify the imaging features and clinical risk factors related to the postoperative survival time of patients with synchronous liver metastasis(sCRLM)of colorectal cancer,so as to guide the decision-making of clinical treatment.Methods:69 patients with sCRLM who underwent primary or secondary resection were included.The clinical and imaging factors were extracted and the patients were followed up to obtain the survival time for analysis.Results:Effective follow-up information was obtained in 57 patients.The difference of survival time between the two surgical methods was not statistically significant(P>0.05).Multivariate COX regression analysis showed that clinical CRS score,necrosis within the metastatic foci,and primary foci breaking through serous membrane were independent predictors of prognosis.Conclusions:There was no significant difference in survival time between patients undergoing primary or secondary surgical resection.Clinical CRS score,necrosis within the metastatic foci,and primary tumor growth through the serous membrane could be used as prognostic factors.

关 键 词：结直肠肿瘤 肝转移 预后 体层摄影术 X线计算机 磁共振成像 

分 类 号：R735.3[医药卫生—肿瘤] R814.42[医药卫生—临床医学]