中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2009年
3期
220-222
,共3页
方桦%王兴元%王金万%张弘纲%冯奉仪%石远凯
方樺%王興元%王金萬%張弘綱%馮奉儀%石遠凱
방화%왕흥원%왕금만%장홍강%풍봉의%석원개
结直肠肿瘤%肝转移%预后
結直腸腫瘤%肝轉移%預後
결직장종류%간전이%예후
Colorectal neoplasms%Liver metastases%Prognosis
目的 探讨结直肠癌肝转移患者的临床特征及预后因素.方法 对300例结直肠癌首发肝转移患者的临床特征及肝转移后的生存情况进行回顾性分析.结果 300例患者中,原发病灶位于结肠者152例,位于直肠者148例.原发肿瘤为管状腺癌272例,黏液腺癌18例,类癌5例,印戒细胞癌4例,鳞癌1例.原发肿瘤为高分化19例,中分化217例,低分化27例.无区域淋巴结转移104例,有区域淋巴结转移162例.原发肿瘤分期为Ⅰ、Ⅱ期62例,Ⅲ、Ⅳ期为237例.同时性肝转移206例,异时性肝转移94例.肝转移灶为单发48例,多发252例.肝转移灶最大直经≤5 cm249例,>5 cm 51例.300例患者转移后中位生存期为19.0个月,肝转移后1、2和5年生存率分别为79.0%、29.0%和3.0%.单因素分析结果显示,患者KPS评分、组织学分级、原发肿瘤T分期、有无区域淋巴结转移、原发肿瘤分期、有无脉管瘤栓、肝转移灶部位、肝转移灶最大直径、肝转移灶数目、同时合并其他转移均与预后有关.多因素分析结果显示,KPS评分、脉管瘤栓、肝转移灶数目、肝转移灶最大直径是结直肠癌肝转移患者预后的独立影响因素.结论 KPS评分、脉管瘤栓、肝转移灶数目和最大直径是结直肠癌肝转移患者预后的影响因素,KPS评分越高、无脉管瘤栓、肝转移灶数目越少、转移灶最大直径越小的患者预后越好.
目的 探討結直腸癌肝轉移患者的臨床特徵及預後因素.方法 對300例結直腸癌首髮肝轉移患者的臨床特徵及肝轉移後的生存情況進行迴顧性分析.結果 300例患者中,原髮病竈位于結腸者152例,位于直腸者148例.原髮腫瘤為管狀腺癌272例,黏液腺癌18例,類癌5例,印戒細胞癌4例,鱗癌1例.原髮腫瘤為高分化19例,中分化217例,低分化27例.無區域淋巴結轉移104例,有區域淋巴結轉移162例.原髮腫瘤分期為Ⅰ、Ⅱ期62例,Ⅲ、Ⅳ期為237例.同時性肝轉移206例,異時性肝轉移94例.肝轉移竈為單髮48例,多髮252例.肝轉移竈最大直經≤5 cm249例,>5 cm 51例.300例患者轉移後中位生存期為19.0箇月,肝轉移後1、2和5年生存率分彆為79.0%、29.0%和3.0%.單因素分析結果顯示,患者KPS評分、組織學分級、原髮腫瘤T分期、有無區域淋巴結轉移、原髮腫瘤分期、有無脈管瘤栓、肝轉移竈部位、肝轉移竈最大直徑、肝轉移竈數目、同時閤併其他轉移均與預後有關.多因素分析結果顯示,KPS評分、脈管瘤栓、肝轉移竈數目、肝轉移竈最大直徑是結直腸癌肝轉移患者預後的獨立影響因素.結論 KPS評分、脈管瘤栓、肝轉移竈數目和最大直徑是結直腸癌肝轉移患者預後的影響因素,KPS評分越高、無脈管瘤栓、肝轉移竈數目越少、轉移竈最大直徑越小的患者預後越好.
목적 탐토결직장암간전이환자적림상특정급예후인소.방법 대300례결직장암수발간전이환자적림상특정급간전이후적생존정황진행회고성분석.결과 300례환자중,원발병조위우결장자152례,위우직장자148례.원발종류위관상선암272례,점액선암18례,유암5례,인계세포암4례,린암1례.원발종류위고분화19례,중분화217례,저분화27례.무구역림파결전이104례,유구역림파결전이162례.원발종류분기위Ⅰ、Ⅱ기62례,Ⅲ、Ⅳ기위237례.동시성간전이206례,이시성간전이94례.간전이조위단발48례,다발252례.간전이조최대직경≤5 cm249례,>5 cm 51례.300례환자전이후중위생존기위19.0개월,간전이후1、2화5년생존솔분별위79.0%、29.0%화3.0%.단인소분석결과현시,환자KPS평분、조직학분급、원발종류T분기、유무구역림파결전이、원발종류분기、유무맥관류전、간전이조부위、간전이조최대직경、간전이조수목、동시합병기타전이균여예후유관.다인소분석결과현시,KPS평분、맥관류전、간전이조수목、간전이조최대직경시결직장암간전이환자예후적독립영향인소.결론 KPS평분、맥관류전、간전이조수목화최대직경시결직장암간전이환자예후적영향인소,KPS평분월고、무맥관류전、간전이조수목월소、전이조최대직경월소적환자예후월호.
Objective To analyse the clinical characteristics and potential prognostic factors of colorectal cancer patients with liver metastases. Methods The clinical and pathological data of 300 colorectal cancer patients with liver metastases were retrospectively reviewed and annalyzed. Results The median survival time of these patients was 19.0 months. The 1-, 2-and 5-year survival rates after liver metastases were 79.0%, 29.0% and 3.0%, respectively. Univariate analysis revealed that performance status (KPS), histological grading, primary tumor, N status, lymphatic and vascular invasion, stage at diagnosis, the number, size and distribution of liver metastases and other accompanied metastases were prognostic factors. Multivariate analysis showed that KPS, lymphatic and vascular invasion, the number and size of liver metastases were independent prognostic factors of colorectal cancer with liver metastases. Conclusion Performance status, lymphatic and vascular invasion, the number and size of liver metastases are independent prognostic factors of colorectal cancer with liver metastases.
