淋巴结阴性结肠癌伴同时性肝转移患者的临床病理因素-中国肿瘤临床.pdf

中国肿瘤临床2016年第43卷第5期 ChinJClinOncol2016.Vol.43.No.5 183 临床研究与应用 · · 淋巴结阴性结肠癌伴同时性肝转移患者的临床病理因素分析* 张成海 苏向前 崔明 邢加迪 杨宏 姚震旦 张楠 摘要 目的：分析淋巴结阴性结肠癌患者发生同时性肝转移的危险因素，提高高危患者随访的效率和早诊率。方法：回顾性分析 2008年1月至2012年12月就诊北京肿瘤医院胃肠肿瘤中心并且行手术治疗的140例淋巴结阴性结肠癌患者临床病理资料，通过 单因素和多因素分析，研究淋巴结阴性结肠癌同期肝转移的高危因素。结果：140例淋巴结阴性结肠癌患者同期肝转移13例 （9.2%），61.5%（8/13例）的患者伴有不全性结肠梗阻，6例患者接受原发灶和肝转移灶同期手术治疗。单因素分析和多因素分析 均提示脉管浸润（P=0.010）和术前CEA水平异常（P=0.004）是淋巴结阴性结肠癌患者发生同时性肝转移的独立危险因素。结论： 淋巴结阴性结肠癌存在较高的同时性肝转移风险，脉管浸润和术前CEA水平异常是这类患者发生同期肝脏转移的高危因素，对 具有该特征的患者在就诊时或根治术后应该针对性地检查肝脏情况，避免漏诊。 关键词 结肠癌 同时性肝脏转移 淋巴结阴性 危险因素 doi:10.3969/j.issn.1000-8179.2016.05.031 Analysis of clinicopathological factors for node- negative colon cancer patients with synchronous liver metastases Chenghai ZHANG, Xiangqian SU, Ming CUI, Jiadi XING, Hong YANG, Zhendan YAO, Nan ZHANG Correspondence to: Xiangqian SU; E-mail: suxiangqian@ Department of Gastrointestinal Surgery Ⅳ, Peking University Cancer Hospital Institute, Key Laboratory of Carcinogenesis and Trans- lational Research (Ministry of Education), Beijing 100142, China This work was supported by the National Natural Science Foundation of China (No. , Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (No. XM201309), Peking University (PKU) 985 Special Funding for Collaborative Research with PKU Hospitals Abstract Objective: To explore the clinicopathological factors in node-negative colon cancer patients with synchronous liver metasta- ses and to improve the efficiency of follow-up and rate of early diagnosis for high-risk patients. Methods: Clinical data of 140 colon cancer patients who underwent operation from January 2008 to December 2012 in Beijing Cancer Hospital were ana