大肠癌肝转移的相关因素及手术治疗效果的回顾性分析

doi:10.3877/cma.j.issn.2095-3224.2017.03.016

目的

探讨大肠癌肝转移的相关因素及手术治疗效果。

方法

回顾分析北京中医医院2010年1月至2015年12月间30例大肠癌肝转移患者的手术治疗和非手术治疗的效果，并选同期30例大肠癌非肝转移患者为对照，分析影响大肠癌肝转移的危险因素；采用Kaplan-Meier法对大肠癌肝转移患者进行生存分析并绘制生存曲线，采用log rank检验对手术与非手术治疗的生存曲线进行比较。

结果

大肠癌肝转移患者中，肿瘤大于5 cm（Χ²=4.344，P<0.05）及发生脉管癌栓（Χ²=4.593，P<0.05）的患者数量明显多于非肝转移患者；肝转移患者中，手术组和保守组中位生存时间分别是（37.200±4.857）月和（20.333±4.722）月，另外log rank检验得出：手术组五年累积生存率明显高于保守组（P=0.045）。

结论

肿瘤大小、脉管癌栓是大肠癌发生肝转移的危险因素，对大肠癌肝转移患者实施手术治疗可提高患者短期生存率。

关键词: 结直肠肿瘤, 肿瘤转移, 回顾性分析

Objective

To explore the related factors and the effect of surgical treatment for colorectal cancer patients with liver metastasis.

Methods

Retrospective analysis the surgical and non-surgical treatment for 30 cases of patients with colorectal liver metastases from January 2010 to December 2015, and chose the colorectal cancer patients without liver metastases at the same period as the control group, and then, analysis the risk factors of colorectal liver metastases. To use the Kaplan-Meier method to analyze the accumulation survival rate for colorectal cancer patients with liver metastasis and to draw the cumulative survival curve, thus, to compare the cumulative survival curve of surgical and non-surgical treatment through the log rank test.

Results

The number of patients whose tumor size were greater than 5 cm and suffered with vascular tumor emboli among colorectal cancer patients with liver metastasis were more than colorectal cancer patients without liver metastasis (Χ²=4.344, Χ²=4.593, all P<0.05). Among these patients with liver metastasis, the median survival time of surgical group and conservative group were (7.200±4.857) months and (20.333±4.722) months respectively. And the log rank test showed that the 5-year cumulative survival rate of the surgical groups was significantly higher than that of the conservative group (P=0.045).

Conclusion

Tumor size and vascular tumor emboli are the risk factors for colorectal cancer patients with liver metastases, and the therapy of surgical treatment can improve the short-term survival rate for them.

Key words: Colorectal neoplasms, Neoplasm metastasis, Retrospective analysis

表1 结肠癌患者发生肝转移的单因素分析［例（%）］

组别	例数	肿瘤大小		肿瘤分化程度				脉管癌栓
组别	例数	1~5 cm	>5 cm	G1	G2	G3	G4	脉管癌栓
肝转移组	30	17	13	13	5	8	7	15
非肝转移组	30	9	21	10	7	6	7	7
X²值	?	?	4.344	0.635	?	?	?	4.593
P值	?	?	0.037	0.462	?	?	?	0.032

表1 结肠癌患者发生肝转移的单因素分析［例（%）］

组别	例数	肿瘤大小		肿瘤分化程度				脉管癌栓
组别	例数	1~5 cm	>5 cm	G1	G2	G3	G4	脉管癌栓
肝转移组	30	17	13	13	5	8	7	15
非肝转移组	30	9	21	10	7	6	7	7
X²值	?	?	4.344	0.635	?	?	?	4.593
P值	?	?	0.037	0.462	?	?	?	0.032

图1 大结肠癌肝转移手术治疗与非手术治疗患者的累积生存曲线

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A retrospective analysis of the related factors and effect of surgical treatment for colorectal cancer patients with liver metastasis

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A retrospective analysis of the related factors and effect of surgical treatment for colorectal cancer patients with liver metastasis