摘要
背景与目的:影响结直肠癌肝转移预后的因素仍未明确,本文旨在探讨影响结直肠癌肝转移预后的相关临床病理因素。方法:选择中山大学肿瘤防治中心1996年1月至2000年12月收治的197例结直肠癌肝转移患者,分析临床病理因素与预后的关系。根据Cox回归模型的结果计算预后指数(prognosticindex,PI),并根据PI值将患者分为不同的危险组,比较各组的生存率。结果:全组总的1、3、5年生存率分别为59.04%、17.73%、11.48%。单因素分析显示,有无肝外病变、原发灶切除、肝转移瘤切除、肿瘤大体类型、血清CEA水平、肝转移瘤数目、大小、分布与结直肠癌肝转移的预后有关;多因素分析显示,肝转移瘤切除、血清CEA水平、肝转移瘤数目和大小与预后有关。根据PI值将患者分为高危组、中危组和低危组,3组的生存率两两间存在显著性差异(P<0.05)。结论:肝转移瘤切除、血清CEA水平、肝转移瘤数目和大小是影响结直肠癌肝转移预后的的重要因素,对于可行肝转移灶切除的患者应积极手术治疗,以提高患者的生存率;PI值可用于结直肠癌肝转移患者的预后估计。
BACKGROUND ＆ OBJECTIVE, It is not very clear about the factors that affect the prognosis of liver metastases from colorectal cancer. This study was to investigate the clinicopathologic factors related to the prognosis of liver metastases from colorectal cancer. METHODS, The clinicopathologic factors and follow-up data of 197 patients with liver metastases from colorectal cancer, treated from Jan. 1996 to Dec. 2000, were analyzed retrospectively. The prognostic index （PI） of patients was calculated based on the results of multivariate analysis and patients were classified into different hazard groups accordingly. RESULTS, The overall 1-, 3-, and 5-year survival rates were 59.04%, 17.73%, and 11.48%. Univariate analysis revealed that extrahepatic invasion, primary tumor resection, liver metastasis resection, type of primary tumor, serum CEA concentration, number and size of liver metastases, and distribution of liver metastases were associated with prognosis. Multivariate analysis identified that the resection of liver metastases, serum CEA concentration, number and size of liver metastases were prognostic factors. The patients were classified into high risk, moderate risk, and low risk groups according to the PI value, and there was significant difference in survival rates between each two groups. CONCLUSIONS. Liver metastasis resection, serum CEA concentration, number and size of liver metastases are important prognostic factors for liver metastases from colorectal cancer. In order to improve the survival rate, liver metastases should be resected for suitable patients. Moreover, PI value could be used to predict the prognosis of patients with liver metastases from colorectal cancer.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2006年第9期1149-1152,共4页
Chinese Journal of Cancer
关键词
结直肠肿瘤
肝肿瘤/继发性
预后
多因素分析
Colorectal neoplasms
Liver metastases/secondary
Prognosis
Multivariate regressive analysis
