乙肝表面抗原等因素对结直肠癌肝转移的影响

目的本研究将探讨乙肝表面抗原（HBsAg）等多项临床因素对结直肠癌肝转移的影响,为进一步治疗结直肠癌肝转移提供新的研究思路及方向。 方法回顾性分析青岛大学医学院附属医院2010年1月至2011年6月病理证明的结直肠癌患者892例。收集患者的相关临床资料（包括乙肝表面抗原、年龄、术前相关实验室检查、术后病理结果等）,研究是否会影响肝转移的发生。 结果结直肠癌是否发生肝转移两组患者在性别、年龄、肿瘤发生部位、大小、病理组织类型、是否造口、血清白蛋白、总胆红素及谷草转氨酶等方面相比,差异均无统计学意义（χ²=0.359,Z=-1.631,χ²=0.003,χ²=1.223,χ²=0.619,χ²=0.516,Z=-3.235,Z=-0.106,Z=-0.328;均P>0.05）。HBsAg阳性较阴性患者发生肝转移几率明显降低,差异有统计学意义（χ²=5.809,P<0.05）。另外,肝转移与分化水平（χ²=14.165,P<0.01）、浸润程度（χ²=17.808,P<0.01）以及淋巴结转移数目（χ²=41.798,P<0.01）有关,差异均有统计学意义。多因素logistic回归分析结果表示乙肝病毒表面阳性患者肝转移发生低,而低分化、浸润程度高、淋巴结转移多者肝转移率高。 结论乙型肝炎病毒表面抗原阳性会降低肝转移的发生几率。分化程度越低、浸润程度越高、淋巴结转移数多,越容易发生肝转移。

Effects of hepatitis B surface antigen and other factors on liver metastasis of colorectal

ObjectiveThe study will explore the effect of HBsAg and other clinical factors on liver metastasis of colorectal cancer, and provide new research ideas and direction for further treatment of liver metastasis of colorectal cancer. MethodsRetrospective analysis of Affiliated Hospital of Qingdao University Medical College in January 2010 to June 2011 with pathology confirmed 892 cases of colorectal cancer patients. The clinical data (including hepatitis B surface antigen, age, preoperative related laboratory examination, postoperative pathological results) were collected to determine whether the incidence of liver metastasis was affected. ResultsThere was no statistically significant difference compared to two groups of gender age, tumor location, tumor size, histological type, whether the stoma, serum albumin, serum bilirubin, ALP (χ²=0.359, Z=-1.631, χ²=0.003, χ²=1.223, χ²=0.619, χ²=0.516, Z=-3.235, Z=-0.106, Z=-0.328; P>0.05). HBsAg positive patients can significantly reduce the incidence of liver metastasis than negative patients, there was a significant statistical difference (χ²=5.809, P<0.05). In addition, the degree of liver metastasis and differentiation (χ²=14.165, P<0.01), the degree of infiltration (χ²=17.808, P<0.01) and the number of lymph node metastasis (χ²=41.798, P<0.01) , the difference was statistically significant. Multivariate logistic regression analysis showed that hepatitis B virus-positive patients with liver metastasis occurred low, and poorly differentiated, high degree of invasion, lymph node metastasis and high liver metastases. ConclusionHepatitis B virus surface antigen positive will reduce the incidence of liver metastases. The lower degree of differentiation, the higher degree of infiltration, the number of lymph node metastasis, are the factors more prone to liver metastasis.