结直肠癌肝转移患者预后影响因素分析

Prognosis influencing factors of patients with liver metastases of colorectal cancer

目的 分析结直肠癌肝转移患者预后的影响因素。方法 对148例结直肠癌肝转移患者的临床特征及生存资料进行回顾性分析,采用多元逐步Cox回归分析模型探讨影响患者预后的相关因素。结果 148例结直肠癌肝转移患者1、3、5年生存率依次为77.7%、29.1%、12.8%。结直肠癌组织学分级为低分化（HR=2.86,95%CI：1.52~5.39）、肝转移癌类型为H2（HR=1.86,95%CI：1.05~3.28）或H3（HR=2.14,95%CI：1.30~3.54）为结直肠癌肝转移患者预后的独立危险因素,手术治疗（HR=0.54,95%CI：0.31~0.95）和局部治疗（HR=0.72,95%CI：0.53~0.97）为结直肠癌肝转移患者预后的独立保护因素。结论 结直肠癌组织学分级低、肝转移癌类型为H2/H3结直肠癌肝转移患者预后风险增加,手术治疗和局部治疗的结直肠癌肝转移患者预后风险降低。

Objective To analyze the prognosis influencing factor of patients with liver metastases of colorectal cancer. Methods Clinical features and survival data of 148 cases with liver metastases of colorectal cancer were retrospectively analyzed. Cox regression analysis was used to detect relative factors. Results Survival rates of 148 cases after 1,3 and 5 years were respectively 77.7% , 29.1% and 12.8%. Histological grade of eolorectal cancer was poorly differentiated （HR = 2. 86, 95% CI： 1.52-5.39）, hepatic metastasis type was H2 （HR = 1.86, 95% CI： 1.05-3.28 ） or H3 （HR = 2. 14, 95%CI：1.30-3.54） which were independent risk factors. Operative treatment （HR =0. 54, 95% CI：0. 31-0.95） and local treatment （HR = 0. 72, 95 % CI：0. 53-0.97 ） was independent protective factors for the prognosis of patients with liver metastases of eolorectal cancer. Conclusion Histological grade of coloreetal cancer is poor, the prognostic risk of patients with hepatic metastasis H2/H3 is increased, and surgical treatment and local treatment may lower the risk of patients with liver metastases of colorectal cancer.