Ⅱ～Ⅲ期结直肠癌术后肝转移危险因素分析

Analysis of risk factors of postoperative hepatic metastasis in patients with stage Ⅱ-Ⅲ colorectal cancer

目的探讨Ⅱ～Ⅲ期结直肠癌患者术后肝转移的危险因素。方法回顾性分析2011年3月～2015年3月间150例Ⅱ～Ⅲ期结直肠癌患者在本院行手术治疗的患者资料,采用Cox比例风险模型分析术后肝转移的危险因素。结果术后3年内共60例患者出现肝转移,3年无肝转移生存率为60%。Cox单因素分析提示术前CEA水平(P=0.0005)、肿瘤分化(P=0.0121)和肿瘤分期(P=0.0001)与术后肝转移明显相关。Cox多因素分析提示术前CEA水平(P=0.0090)、肿瘤分化(P=0.0188)和肿瘤分期(P=0.0013)与术后肝转移明显相关。结论术前CEA水平、肿瘤分化和肿瘤分期是Ⅱ～Ⅲ期结直肠癌患者术后发生肝转移的危险因素,对具有危险因素的患者应加强随访,采用合理的术后辅助化疗方案以降低术后肝转移发生率,改善长期生存。

Objective To investigate the risk factors of postoperative hepatic metastasis in patients with stage Ⅱ～Ⅲ eoloreetal cancer. Methods The data of 150 patients with stage Ⅱ～Ⅲ eoloreetal cancer who underwent surgery in our hospital from March 2011 to March 2015 were retrospectively analyzed. Cox proportional hazards model was used to analyze the risk factors for postoperative liver metastases. Results A total of 60 patients developed hepatic metastases within 3 years after surgery, and the 3-year liver metastasis-free survival rate was 60%. Cox univariate analysis re- vealed that preoperative CEA levels （P=0.0005）, tumor differentiation （P=0.0121）, and tumor stage （P=0.0001） were significantly associated with postoperative liver metastases. Cox muhivariate analysis revealed that preoperative CEA levels （P=0.0090）, tumor differentiation （P=0.0188）, and tumor stage （P=0.0013） were significantly associated with postoperative liver metastases. Conclusion Preoperative CEA levels, tumor differentiation, and tumor stage were risk factors for postoperative hepatic metastasis in patients with stage Ⅱ～Ⅲ eoloreetal cancer. Patients with risk factors should be followed up with reasonable postoperative adjuvant chemotherapy to reduce the incidence of postoperative liver metastases and to improve long-term survival.