结直肠癌肝转移的危险因素分析138例

目的:探讨影响结直肠癌肝转移的危险因素.方法:采用Kaplan-Meier和多因素回归分析方法,分析138例有完整随访资料的结直肠癌肝转移患者的生存情况及影响预后的相关因素.结果:138例患者的中位生存时间为18.3mo.单因素分析显示,患者年龄(P=0.460)、原发肿瘤部位(P=0.568)、原发肿瘤最大直径(P=0.250)、原发肿瘤组织学分级(P=0.589)与患者的总生存时间无关,而性别(P=0.048)、治疗前血清CEA水平(P=0.023)、肝转移灶数目(P=0.000)、肝转移灶最大直径(P=0.001)、区域淋巴结转移情况(P=0.001)、肝转移灶手术与否(P=0.002)与患者的预后有关.多因素回归分析显示,治疗前血清CEA水平(P=0.028)、肝转移灶数目(P=0.001)、肝转移灶最大直径(P=0.001)、区域淋巴结转移情况(P=0.049)、肝转移灶手术与否(P=0.003)是影响结直肠癌肝转移患者预后的主要因素.结论:治疗前血清CEA水平、肝转移灶数目、肝转移灶最大直径、区域淋巴结转移情况、肝转移灶手术与否是结直肠癌肝转移患者预后的影响因素;治疗前血清CEA水平越低、肝转移灶数目越少、肝转移灶最大直径越小、无区域淋巴结转移、肝转移灶通过手术治疗的患者预后越好.

Analysis of prognostic factors in patients with colorectal cancer with liver metastases

AIM: To explore prognostic factors in patients with colorectal cancer with liver metastases. METHODS: The survival and prognostic factors in 138 patients with liver metastases from colorectal cancer, who had complete follow-up data, were retrospectively assessed by Kaplan-Meier analysis and multivariate regression analysis. RESULTS: The median survival time of the 138 patients was 18.3 months. Univariate analysis demonstrated that age (P = 0.460), primary tumor site (P = 0.568), primary tumor size (P = 0.250), and histological grade of primary tumor (P = 0.589) had no significant correlation with the overall survival. However, gender (P = 0.048), pretreatment serum CEA level (P = 0.023),number (P = 0.000) and size (P = 0.001) of liver metastases, lymphatic invasion (P = 0.001), and resection of liver metastases (P = 0.002) were all independently related with the prognosis of patients. Multivariate regression analysis showed that pretreatment serum CEA level (P = 0.028), number (P = 0.001) and size (P = 0.001) of liver metastases, lymphatic invasion (P = 0.049), and resection of liver metastases (P = 0.003) were key factors affecting the prognosis of patients with liver metastases from colorectal cancer. CONCLUSION: Pretreatment serum CEA level, number and size of liver metastases, lymphatic invasion, and resection of liver metastases are independent prognostic factors for colorectal cancer with liver metastases.