结直肠癌根治术后肝转移的相关影响因素分析  

Analysis of Related Factors of Liver Metastasis After Radical Resection of Colorectal Cancer

作　　者：宋青青 李长生[1] 张英丽[1] SONG Qingqing;LI Changsheng;ZHANG Yingli(Nanyang Central Hospital,Nanyang,473000)

机构地区：[1]河南省南阳市中心医院,473000

出　　处：《实用癌症杂志》2023年第1期115-118,共4页The Practical Journal of Cancer

摘　　要：目的 探讨结直肠癌根治术后肝转移的相关影响因素,为临床预防策略制定提供指导。方法 选取112例结直肠癌患者,所有患者均行结直肠癌根治术。术后长期随访,依据是否发生肝转移分为转移组与未转移组,收集2组年龄、性别、体质量指数、肿瘤分期、发病部位、术前癌胚抗原(CEA)水平、分化程度、肿瘤浸润深度、术中输血、淋巴结转移、术后辅助化疗、脉管瘤栓、手术时间、肿瘤直径等多方面信息,先对上述资料进行单因素分析,获取有统计学差异的数据后开展Logistic回归分析,明确结直肠癌根治术后肝转移的独立危险因素。结果 112例结直肠癌患者术后肝转移24例,肝转移发生率为21.43%(24/112)。单因素分析显示,肿瘤分期、术前CEA水平、分化程度、肿瘤浸润深度、淋巴结转移、术后辅助化疗、脉管瘤栓、肿瘤直径与结直肠癌根治术后肝转移有关,差异有统计学意义(P<0.05);多因素分析显示,肿瘤分期Ⅲ期、术前CEA水平≥5 ng/mL、低分化、肿瘤浸润深度T4、淋巴结转移、术后未辅助化疗、脉管瘤栓、肿瘤直径≥3 cm为影响结直肠癌术后肝转移的独立危险因素(P<0.05且OR>1)。结论 结直肠癌术后存在较高肝转移风险,肿瘤分期Ⅲ期、术前CEA水平≥5 ng/mL、低分化、肿瘤浸润深度T4、淋巴结转移、术后未辅助化疗等为独立影响因素,临床需采取针对性干预,以减少肝转移发生,改善患者预后。Objective To explore the related factors of liver metastasis after radical resection of colorectal cancer, and to provide guidance for the formulation of clinical prevention strategies.Methods Clinical data of 112 patients with colorectal cancer were selected.All patients underwent radical resection of colorectal cancer.After long-term follow-up, they were divided into metastasis group and non metastasis group according to whether liver metastasis occurred.The age, sex, body mass index, tumor stage, location of onset, preoperative carcinoembryonic antigen(CEA) level, degree of differentiation, depth of tumor invasion, intraoperative blood transfusion, lymph node metastasis, postoperative adjuvant chemotherapy, vascular tumor thrombus, operation time, tumor diameter and other information of the 2 groups were collected, First, univariate analysis was performed on the above data, and then logistic regression analysis was carried out to identify the independent risk factors of liver metastasis after radical resection of colorectal cancer.Results Among 112 patients with colorectal cancer, 24 cases had liver metastasis after operation, and the incidence of liver metastasis was 21.43%(24/112);Univariate analysis showed that tumor stage, preoperative CEA level, degree of differentiation, depth of tumor invasion, lymph node metastasis, postoperative adjuvant chemotherapy, vascular tumor thrombus, and tumor diameter were related to liver metastasis after radical resection of colorectal cancer, and the difference was statistically significant(P<0.05);Multivariate analysis showed that tumor stage Ⅲ,preoperative CEA level ≥ 5 ng/ml, low differentiation, tumor invasion depth T4,lymph node metastasis, postoperative non adjuvant chemotherapy, vascular tumor thrombus, and tumor diameter ≥ 3 cm were independent risk factors for liver metastasis after colorectal cancer surgery(P<0.05 and or > 1).Conclusion Colorectal cancer has a high risk of liver metastasis after operation.Tumor stage Ⅲ,preoperative CEA level ≥ 5 ng/ml,

关 键 词：结直肠癌 结直肠癌根治术 肝转移 影响因素 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]