结直肠癌肾上腺转移的诊治

Diagnosis and treatment of adrenal metastasis from colorectal cancer

目的 探讨结直肠癌肾上腺转移的临床特点，提高其诊治水平。方法 回顾性总结2001年1月至2006年12月收治的17例结直肠癌肾上腺转移患者的临床资料。结果结直肠癌肾上腺转移发生率为1．18％（17／1437），同时性结直肠癌肾上腺转移5例，异时性12例。孤立肾上腺转移1例，其余均合并其他部位转移。16例肿瘤标志物异常。孤立肾上腺转移采用手术切除，至今已存活16个月；其余采用辅助化疗，平均生存时间10．8个月。结论 本病表现隐匿，肿瘤标志物结合影像学检查能够确诊。对于原发灶能够切除的患者，尽量同时切除肾上腺转移灶，能使患者获得长期生存；对于不能完整切除的患者，选择综合治疗方案，延长其生存时间。

Objective To analyze the clinical characteristic of adrenal metastasis from colorectal cancer to improve its diagnosis and treatment. Methods The clinical data of 17 patients with adrenal metastasis from colorectal cancer admitted in our department from January 2001 to December 2006 were analyzed retrospectively. Results The incidence of adrenal metastasis from colorectal cancer was 1.18% （ 17/1437 ）. Synchronous adrenal metastasis from colorectal cancer occurred in 5 patients, and metachronous adrenal metastasis from colorectal cancer in 12. The tumor marker of 16 patients was abnormal. One patient with isolated adrenal metastases underwent operative resection, and survived till today （16 months）; the other 16 patients with adrenal and other organ metastasis received adjuvant chemotherapy, and their mean survival time was 10. 8 months. Conclusions Although the clinical symptom of adrenal metastasis from colorectal cancer is obscure, tumor marker combined with imaging examination can accurately diagnose. For patients whose primary tumor can be resected, simultaneous resection of adrenal metastasis foci is necessary to prolong the patients＇ lifespan; for patients whose primary tumor can not be completely resected, comprehensive treatment should be chosen.