结直肠癌同时及异时性远处转移的临床病理特征

目的:回顾性分析结直肠癌同时性与异时性远处转移患者的临床病理特征及预后影响因素.方法:收集2010年1月至2015年12月间128例结直肠癌远处转移患者完整的临床病理资料,根据转移发生的时间分为两组:同时转移组(79例)、异时转移组(49例).比较两组临床病理特征,分析影响远处转移患者预后的因素.结果:同时性远处转移患者与肿瘤原发部位(P=0.025)、浸润深度(P=0.002)、分化程度(P=0.008)及脉管癌栓(P=0.012)有关;同时性远处转移患者中位生存期为19(12~28)个月,异时性远处转移患者中位生存期为20(13~28)个月,两组之间差异无统计学意义(P=0.866);多因素生存分析结果提示,肿瘤浸润深度(P<0.001)、肿瘤分化程度(P=0.002)、脉管癌栓(P=0.006)及转移器官数量(P=0.001)是影响远处转移预后的独立因素.结论:根据结直肠癌不同时期发生远处转移患者表现出的临床病理特点,可以有效估计可能发生远处转移的患者及预后情况.

Clinicopathological features of colorectal carcinoma patients with synchronous and metachronous metastasis

Objective: To review the clinicopathological features and prognostic factors of colorectal carcinoma patients with synchronous and metachronous metastasis.Methods: The clinicopathologic data of 128 colorectal carcinoma patients with distant metastasis were admitted between January 2010 and December 2015. These patients were divided into two groups according to the time of metastasis: the synchronous metastasis group (n=79) and the metachronous metastasis group (n=49). The clinicopathological characteristics of two groups were compared, and the prognostic factors of patients with metastasis were analyzed.Results: The primary site of tumor (P=0.025), inflltration depth (P=0.002), degree of diflerentiation (P=0.008) and vascular invasion (P=0.012) were related with synchronous metastasis in colorectal carcinoma. The media survival time was 19 (12-28) months in the synchronous group, 20 (13-28) months in the metachronous group, the diflerence was not statistically signiflcant (P=0.866). Multivariate analysis found that tumor infiltration depth (P<0.001), degree of differentiation (P=0.002), vascular invasion (P=0.006), number of metastasis were independent prognostic factors for colorectal carcinoma patients with distant metastasis.Conclusion: The possibility of distant metastasis and the prognosis of the patients with distant metastasis in colorectal carcinoma can be estimated according to the clinicopathological characteristics.