结肠癌术后肝转移危险因素回顾性分析

Retrospective analysis of risk factors of liver metastasis of colon cancer after radical resection

目的探讨影响结肠癌根治术后肝转移的危险因素,为防治结肠癌肝转移提供参考依据。方法选取2009-01-01-2011-01-31在我院行结肠癌根治术的240例患者为研究对象,回顾其临床病理资料及术后随访情况,并采用χ2检验和Logistic回归分析探讨影响结肠癌根治术后肝转移的危险因素。结果 240例行结肠癌根治术患者,60例发生术后肝转移。单因素分析显示,病程(P<0.001)、分化程度(P=0.013)、组织学分型(P=0.008)、脉管侵犯(P<0.001)、淋巴结转移(P<0.001)、清除淋巴结数目(P=0.007)和术前癌胚抗原(carcino-embryonic antiger,CEA)水平(P=0.011)等因素与肝转移的发生相关。多因素Logistic回归法进一步分析显示,病程≥6个月(OR=4.797,P=0.010)、有脉管侵犯(OR=8.457,P=0.001)、有淋巴结转移(OR=7.199,P=0.001)、清除淋巴结数目<12枚(OR=5.841,P=0.012)和乳头状腺癌(OR=4.504,P=0.023)为结肠癌患者根治术后发生肝转移的危险因素。结论病程≥6个月、脉管侵犯、淋巴结转移、清除淋巴结数目<12枚、乳头状腺癌的结肠癌根治术患者术后发生肝转移的风险增大,应作为结肠癌术后重点关注的对象。

OBJECTIVE To investigate the rick factors of liver metastasis of colon cancer after radical resection and provide a reference for the prevention and treatment of liver metastasis of colon cancer. METHODS Totally 240 patients who had radical resection of colon cancer in our hospital between Jan. lst,2009 and Jan. 31st,2011 were selected as the study subjects. The clinical pathological data and situation of postoperative follow-up were retrospectively analyzed to find the risk factors of liver metastasis after radical resection of colon cancer by X2 test and Logistic regression analysis. RE- SULTS Sixty cases of 240 patients suffered liver metastases after radical resection of colon cancer. Univariate analysis showed that duration （P〈0. 001） ,degree of tumor differentiation （P：0. 013） ,histological type （P=0. 008） ,vascular in- vasion （P〈0.001）, lymph node metastasis （P〈0.001）, number of nodes dissected （P = 0. 007） and preoperative serum level of CEA （P=0. 011） were relevant to liver metastasis. Logistic regression analysis revealed that the factors such as duration≥ 6 months（ OR = 4.797, P = 0. 010）, vascular invasion （ OR = 8.457, P = 0. 001 ）, lymph node metastasis （ OR = 7. 199, P= 0. 001）, number of nodes dissected〈12 （OR= 5. 841, P= 0. 012）, papillary adenoearcinoma （OR= 4. 504, P = 0. 023） were risk factors for liver metastasis of colon cancer after radical resection. CONCLUSION The patient with du- ration of colon cancer ≥6 months,vascular invasion,lymph node metastasis and the number of nodes dissected%l as well as papillary adenocarcinoma may be more likely to undergo liver metastasis after radical resection.