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中华结直肠疾病电子杂志 ›› 2017, Vol. 06 ›› Issue (04) : 330 -335. doi: 10.3877/cma.j.issn.2095-3224.2017.04.014

所属专题: 经典病例 文献

病例讨论

结直肠癌肝脏、腹主动脉旁淋巴结寡转移的MDT策略
古朝阳1, 邓祥兵2, 王自强2,()   
  1. 1. 610041 成都,四川大学华西医院胃肠外科;610041 成都,四川大学华西临床医学院
    2. 610041 成都,四川大学华西医院胃肠外科
  • 收稿日期:2017-04-16 出版日期:2017-08-25
  • 通信作者: 王自强
  • 基金资助:
    四川省科技厅科技支撑计划(No.2016SZ0043)

MDT strategy for liver and para-aortic lymph node oligometastasis in colorectal cancer

Chaoyang Gu1, Xiangbing Deng2, Ziqiang Wang2,()   

  1. 1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China; West China School of Medicine, Sichuan University, Chengdu 610041, China
    2. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
  • Received:2017-04-16 Published:2017-08-25
  • Corresponding author: Ziqiang Wang
  • About author:
    Corresponding author: Wang Ziqiang, Email:
引用本文:

古朝阳, 邓祥兵, 王自强. 结直肠癌肝脏、腹主动脉旁淋巴结寡转移的MDT策略[J]. 中华结直肠疾病电子杂志, 2017, 06(04): 330-335.

Chaoyang Gu, Xiangbing Deng, Ziqiang Wang. MDT strategy for liver and para-aortic lymph node oligometastasis in colorectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2017, 06(04): 330-335.

结直肠癌是最常见的恶性肿瘤之一,发病率和死亡率均居所有肿瘤前列。转移是结直肠癌预后不佳的主要因素之一,其常见转移部位为肝、肺及淋巴结系统等,其中肝脏是结直肠癌血行转移最主要的靶器官之一。针对结直肠癌转移病灶,多学科综合诊疗(MDT),是治疗的最佳选择。而随着多学科诊疗的进展,结直肠癌"寡转移"逐渐被提出,寡转移是指肿瘤生物侵袭性较温和的一段时期,存在于局限性原发灶与广泛性转移之间的过渡阶段,转移瘤的数量有限且转移器官具有特异性。本文通过对2例结直肠癌同时性肝脏寡转移患者(其中一例伴同时性腹主动脉旁淋巴结转移)MDT治疗策略的分析与文献复习,就结直肠癌肝脏及孤立的腹主动脉旁淋巴结(PALN)寡转移的概念及诊治进展做一综述。

Colorectal cancer is one of the most common malignant tumors, the morbidity and mortality rank the forefront of cancers.Metastasis is one of the main factors of poor prognosis in colorectal cancer. The common metastatic sites are the liver, lung and lymph node system, and the liver is one of the most important target organ. For the colorectal cancer metastatic lesions, multidisciplinary team (MDT) is the best choice for treatment.With the progress of multidisciplinary diagnosis and treatment, colorectal cancer ″Oligometastasis″, was gradually raised. The oligometastasis refers to a period in which the tumor is less invasive and has a transitional stage between the primary lesion and the extensive metastasis, the number of metastatic lesions is limited and the metastatic organ is specific.In this study, the MDT treatment strategies of two cases of colorectal cancer patients with synchronous liver metastases (one case with synchronous para-aortic lymph node metastasis) are analyzed and the concept of liver and PALN oligometastasis in colorectal cancer and the progress of treatment are reviewed.

图2 肝脏MRI。图2A,2B分别示:病例一患者新辅助治疗后肝脏MRI显示肝脏转移灶大小约分别为:1.3 cm×0.9 cm,1.0 cm×0.75 cm
图4 肝脏MRI。图4A示:病例二患者新辅助化疗前肝脏MRI显示肝转移灶大小约为:3.9 cm×2.5 cm;图4B示:病例二患者新辅助化疗后肝脏MRI显示肝转移灶大小约为:2.6 cm×1.9 cm
表1 两病例特点比较
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