结直肠癌患者根治性切除术后发生早期肝转移的危险因素分析  

Analysis of Risk Factors for Early Liver Metastasis in Patients with Colorectal Cancer after Radical Resection Surgery

作　　者：马修栋 MA Xiudong(Department of Surgery,Yuncheng County Second People’s Hospital,Heze 274000,China)

机构地区：[1]山东郓城县第二人民医院外科,山东菏泽274000

出　　处：《中国伤残医学》2025年第5期73-77,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探究结直肠癌患者根治性切除术后发生早期肝转移的危险因素。方法:回顾性分析2020年2月—2023年2月郓城县第二人民医院收治的82例结直肠癌患者资料,所有患者均行根治性切除术,根据其术后肝转移发生情况将其分为转移组、未转移组。收集患者的性别、肿瘤部位、分化程度、手术时间、癌胚抗原(CEA)水平、术后辅助化疗情况等一般资料,采用Logistic回归分析早期肝转移发生的危险因素。结果:82例结直肠癌患者行根治性切除术后,有19例发生肝转移,发生率为23.17%。两组的性别、年龄、肿瘤部位、病理类型、手术时间、高血压、糖尿病情况比较,差异均无统计学意义(P>0.05);两组的病理T(pT)分期、病理N(pN)分期、肿瘤直径、分化程度、CEA水平、术后辅助化疗情况比较,差异均有统计学意义(P<0.05)。Logistic回归分析显示,pT分期T3~T4、pN分期N1~N2、肿瘤≥5cm、低分化、CEA≥5 ng/mL、术后未辅助化疗均是结直肠癌患者根治性切除术后早期肝转移的高危因素(P<0.05)。结论:结直肠癌患者根治性切除术后早期肝转移的发生与癌症分期、肿瘤大小、分化程度、CEA水平、术后辅助化疗情况均相关,临床需加以重视。Objective:To investigate the risk factors of early liver metastasis in patients with colorectal cancer after radical resection surgery.Methods:Data of 82 patients with colorectal cancer admitted to Yuncheng County Second People’s Hospital from February 2020 to February 2023 were retrospectively analyzed.All patients underwent radical resection surgery and were divided into a metastatic group and a non-metastatic group according to the incidence of postoperative liver metastasis.General data such as gender,tumor site,degree of differentiation,operation time,carcinoembryonic antigen(CEA)level,and postoperative adjuvant chemotherapy were collected,and the risk factors of early liver metastasis were analyzed by Logistic regression.Results:After radical resection of 82 patients with colorectal cancer,liver metastasis occurred in 19 cases,the incidence was 23.17%.There were no significant differences in gender,age,tumor site,pathological type,operation time,hypertension and diabetes mellitus between the two groups(P>0.05);there were statistically significant differences in pathological T(pT)stage,pathological N(pN)stage,tumor diameter,differentiation degree,CEA level and postoperative adjuvant chemotherapy between the two groups(P<0.05).Logistic regression analysis showed that pT stage T3~T4,pN stage N1~N2,tumor≥5 cm,low differentiation,CEA≥5 ng/mL,postoperative no adjuvant chemotherapy were high risk factors for early liver metastasis after radical resection of colorectal cancer patients(P<0.05).Conclusion:The occurrence of early liver metastases in patients with colorectal cancer after radical resection surgery is related to cancer stage,tumor size,differentiation degree,CEA level and postoperative adjuvant chemotherapy,which needs clinical attention.

关 键 词：结直肠癌 根治性切除术 早期肝转移 危险因素 

分 类 号：R735.34[医药卫生—肿瘤]