结直肠癌肝转移32例的诊断分析

收集１９８４年１２月～１９９４年１１月间经手术和病理证实的结直肠癌肝转移病人３２例。分析其病史、术前检查结果和肝转移灶的特点，发现病史超过半年、癌肿绕肠管３／４周以上和／或ＣＥＡ异常增高者，肝转移的可能性很大。Ｂ超和ＣＴ是定位诊断的主要方法，但只能发现较大的转移灶，它们在本组的阳性率分别只有３１％和４６．２％。对于高度怀疑肝转移而术中仔细探查仍未发现转移灶者，术后密切随访有助于转移性肝癌的早期诊断。

Evaluation of 32 Liver Metastases from Colorectal Carcinoma

From December 1984 to November 1994,there were 32 patients with liver metastases from colorectal carcinoma confirmed by operation and pathology.Clinical history and findings as well as features of liver metastases disclosed that the likelihood of liver metastasis increased with disease duration longer than a half year as well as involvement of intestinal circumference greater than 3/4 and/or elevation of CEA level.Although ultrasound and CT scan are the main diagnostic methods for liver metastasis,they can only detect those greater than 1cm for CT or 2cm for US.In this study,the accuracy rates of ultrasound and CT were 31%,46.2% respectively.If the patient is suspicious of liver metastasis but fails to be found on laparotomy, postoperative follow-up is necessary for earlier detection of the liver metastasis.