结直肠癌脑转移的临床特点及诊治进展

Clinical Characteristics,Diagnosis and Treatment of Brain Metastasis from Colorectal Cancer

结直肠癌实质脏器转移中脑转移相对少见,临床诊断和治疗技术虽然不断进展,仍不能早期确诊脑转移,也不能显著提高患者生存期及改善生活质量。分析患者的临床病理特征(患者年龄、性别、肿瘤的分期、病理学特征、基因表达状态等)是提高诊断率、制订治疗方案及进行预后评价的主要手段。以磁共振成像结合全身正电子扫描为基础的定期复查是结直肠癌脑转移早期诊断的前提,癌胚抗原和组织恶性脑肿瘤缺失蛋白1等肿瘤标志物可能作为结直肠癌的有效预后标志,在脑转移的诊断中起作用。

Brain metastasis is relatively rare in the metastasis of colorectal cancer.Although clinical diagnosis and treatment techniques continue to progress,they still cannot realize early brain metastasis diagnosis,nor can they significantly improve patient survival and improve quality of life.Analyzing the clinicopathological characteristics of the patients（patients＇ age,gender,tumor stage,pathological features,gene expression status,etc.） is the main means to improve the diagnostic rate,formulate the treatment plan and evaluate the prognosis.Periodic review based on magnetic resonance combined with whole-body positron scan is the precondition for the early diagnosis of colorectal brain metastasis.Tumor markers such as carcinoembryonic antigen and tissue malignant tumor-deleted protein 1 can be employed as effective prognostic markers for colorectal cancer,playing a role in the diagnosis of brain metastasis.