结直肠癌肝转移危险因素分析

Analysis of risk factors on liver metastasis from colorectal carcinoma

目的:探讨结直肠癌肝转移的危险因素。方法:收集新疆医科大学附属肿瘤医院1995～2002年间诊治的结直肠癌730例临床资料,选择性别、年龄、血型、首发症状、肿瘤大小、组织类型、临床病理分期(Dukes分期)、肠壁侵袭深度、淋巴结转移情况、癌胚抗原(CEA)、肿瘤相关因子群(TSGF)等临床因素,用Logistic回归进行单因素和多因素分析,并对有意义的指标进行相关分析。结果:单因素分析显示,肝转移与肿瘤部位、大小、Dukes分期、肠壁侵袭深度、淋巴结转移情况、CEA等因素有关;多因素分析显示,仅Dukes分期及CEA与肝转移有关;相关分析显示,结直肠癌肝转移的发生与Dukes分期(r=0.349,P=0.000)及CEA水平(r=0.306,P=0.000)呈正相关。结论:Dukes分期及CEA为结直肠癌肝转移的独立危险因素。Dukes分期越晚,肝转移的危险性亦越大。癌胚抗原(CEA)值离正常值越大,肝转移的危险性越大。性别、年龄、血型、首发症状、肿瘤大体类型、组织类型、肿瘤相关因子群(TSGF)等与肝转移无关。

Objective： To investigate the risk factors of hepatic metastasis from colorectal carcinoma. Methods： Seven hundred and thirty patients with colorectal carcinoma diagnosed and treated from 1995 to 2002 in Xinjiang Tumor Hospital were collected to set up the exceldatabase. Single and multifactor analysis and then correlation analysis were used to evaluate the factors concerned by Binary logistic regression （SPSS 11.5 for windows）. Resuits： Location of tumor, tumor size, clinipathological grade, infiltrating depth, lymph node metastasis, serum CEA were related with hepatic metastasis by single factor analysis. Only clinipathalogical grade and serum CEA were related with hepatic metastasis by multiple factor analysis, hepatic metastasis was positively related to the clinipathological grade （r = 0. 349, P =0. 000） and serum CEA （r = 0. 306, P = 0. 000）. Conclusions： Clinipathological grade and serum CEA are the independent risk fantors related with hepatic metastasis from colorectal carcinoma. The higher clinipathological grade, the more ofen hepatic metatasis. The higher serum CEA from normal, the more risk of hepatic metastasis. Sex, age, blood type, symptoms,gross tumor type, differentiation degree, TSGF are not related to hepatic metastasis.