大肠癌同时性肝转移42例诊治体会

THE EXPERIENCE 1N DIAGNOSIS AND TREATMENT OF 42 CASES CARCINOMA OF LARGE INTESTINE WITH HOMOCHRONOUS HEPATIC METASTASIS

本组42例大肠癌均初次手术即发现有肝转移,并经病理诊断证实。只有1例合并肝硬化。术前肝功检查76%转氨酶升高;62%碱性磷酸酶升高,故认为大肠癌病人,如果没有肝炎等肝病并存,应考虑肝转移的可能性。同时配合B超对肝脏检查,可提高早期诊断率。本组不同治疗方法随访结果,原发灶根治性切除并同对进行肝转移灶处理者平均生存期为16.4个月,明显好于其他方法。本文还对手术适应证和其他治疗方法进行了探讨。

The hepatic metastasis were found in all cases of this group at the first time of operation, which were proved by pathological examination.Only one case complicated with hepatic cirrhosis. Preoperation examination of liver functionshowed transaminase increased in 76% of the cases,AKP increased in 62%.The results indicated that hepatic metastasis should be taken into account in the patient of carcinoma of larg intestine who had no hepatic diseases but abnormal values of the above two parameters.With the help of B-mode urtrasonic examination, ratio of early diagnosis can be improved. Among different treatment,the method of resection of the primary lesion along with the hepatic metastasis is the best one,of which the average survival time is 16. 4 months.The indication for operation and other kind of treatmant are also discussed in this article.