结直肠癌原发位置对肝脏转移瘤手术效果的影响  

Effects of primary location of colorectal cancer on surgical outcome of liver metastases

作　　者：庞世刚[1] 韩红波[1] 郭天华[1] Pang Shigang;Han Hongbo;Guo Tianhua(Department of Gastrointestinal Surgery,Binzhou Central Hospital,Binzhou 251700,Shandong Province,China)

机构地区：[1]滨州市中心医院胃肠外科,滨州251700

出　　处：《中国基层医药》2023年第7期1028-1033,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的分析结直肠癌原发位置对肝脏转移瘤手术效果的影响。方法采用横断面研究研究法,对2012年1月至2022年1月滨州市中心医院收治的结直肠癌肝脏转移瘤患者178例展开研究,依据患者术后是否复发将其分为复发组(n=88)和对照组(n=90),对两组患者的各项一般资料和临床资料进行比较,并对差异有统计学意义的因素进一步行logistic多因素分析,明确结直肠癌肝脏转移瘤患者术后复发的危险因素,分析结直肠癌原发位置与各危险因素的相关性,并比较结直肠癌不同原发位置患者的术后12个月的复发情况。结果原发位置为右半结肠[55.68%(49/88)]、淋巴结转移[92.05%(81/88)]、D-二聚体≥ 180 μg/L、白蛋白(Alb)< 29 g/L、新辅助化疗疗效无效/未做[43.18%(33/88)]、临床危险评分高危[53.41%(47/88)]为结直肠癌肝脏转移瘤患者术后复发的危险因素(P=0.024、0.019、0.001、0.028、< 0.001、0.001)。结直肠癌原发位置与淋巴结转移、D-二聚体、临床危险评分存在正相关(P=0.043、0.046、0.030),与Alb、新辅助化疗疗效存在负相关(P=0.004、0.033)。178例结直肠癌肝脏转移瘤患者术后3个月[53.57%(15/70)]、6个月[55.17%(32/70)]、12个月[55.68%(49/70)]时右半结肠原发患者的复发率明显高于左半结肠[32.14%(9/40)、24.14%(14/40)、26.14%(23/40)]和直肠原发患者[14.29%(4/68)、20.69%(12/68)、18.18%(16/68)],差异均有统计学意义(χ^(2)=4.73、7.85、6.27,均P < 0.05)。结论右半结肠、淋巴结转移、D-二聚体、Alb、新辅助化疗疗效、临床危险评分均为结直肠癌肝脏转移瘤患者术后复发的危险因素,原发位置为右半结肠的患者术后复发率较高。Objective To analyze the effects of the primary location of colorectal cancer on the surgical outcome of liver metastases.Methods A cross-sectional study was conducted on 178 patients with liver metastases from colorectal cancer admitted to Binzhou Central Hospital from January 2012 to January 2022.According to whether the patients had recurrence after surgery,they were divided into a recurrence group(n=88)and a control group(n=90).The general and clinical data were compared between the two groups.Logistic multivariate analysis of the factors with statistical significance was further performed to identify the risk factors of postoperative recurrence of liver metastases from colorectal cancer after surgery.The correlation between the primary location of colorectal cancer and each risk factor was analyzed.The recurrence of colorectal cancer was compared anong patients with different primary locations of colorectal cancer at 12 months after surgery.Results Primary location at the right colon[55.68%(49/88),lymph node metastasis[92.05%(81/88)],D-dimer≥180μg/L,albumin<29 g/L,ineffective/no neoadjuvant chemotherapy[43.18%(33/38)],and high-risk clinical risk score[53.41%(47/88)]were risk factors for postoperative recurrence of liver metastases from colorectal cancer after surgery(P=0.024,0.019,0.001,0.028,<0.001,0.001).The primary location of colorectal cancer was positively correlated with lymph node metastasis,D-dimer,and clinical risk score(P=0.043,0.046,0.030),and negatively correlated with albumin and the efficacy of neoadjuvant chemotherapy(P=0.004,0.033).In 178 patients,the recurrence rate of liver metastases from colorectal cancer at 3 months[53.57%(15/70)],6 months[55.17%(32/70)],and 12 months[55.68%(49/70)]was significantly higher in the right colon compared with the left colon[32.14%(9/40),24.14%(14/40),26.14%(23/40)and the rectum[14.29%(4/68),20.69%(12/68),18.18%(16/68)](χ^(2)=4.73,7.85,6.27,all P<0.05).Conclusion Right colon,lymph node metastasis,D-dimer,albumin,neoadjuvant chemotherapy efficacy,and clin

关 键 词：结直肠癌 肿瘤转移 肝肿瘤 复发 转移瘤切除术 D-二聚体 白蛋白 化学疗法 辅助 危险性评估 

分 类 号：R735.34[医药卫生—肿瘤] R735.7[医药卫生—临床医学]