重视结直肠癌肝转移生物学行为的评价

Precise evaluation of biological behavior for colorectal cancer liver metastases

近年来结直肠癌肝转移的发生率逐年升高,手术切除是肝转移患者获得长期生存的重要手段,但是手术切除后复发率达到60%~70%。因此,明确结直肠癌肝转移患者术后复发的高危因素,精准评价肿瘤生物学行为,有助于更好地选择术前治疗方案、局部治疗时机以及手术方式,也是提高肝转移患者手术切除后生存获益的关键。本文详细阐述了目前研究比较明确的影响结直肠癌肝转移术后复发和生存的主要因素,包括临床危险评分、术前化疗反应性、基因状态和原发肿瘤位置。

The incidence of colorectal cancer liver metastases(CRLM)has been gradually increased in recent years.Surgical resection is the most important treatment method for CRLM patients,but the recurrence rate was as high as 60%-70%after surgical resection.Therefore,it is very important to clarify the high-risk prognostic factors for tumor recurrence in patients with CRLM after surgery.Based on the prognostic factors we can accurately evaluate the biological behavior of each patient before surgery and select suitable preoperative chemotherapy regimen,timing and method of localized treatment for them.Thereby the survival benefit from surgical resection of those patients could be maximized.In this article we discussed several important factors affecting the tumor recurrence and survival of patients with CRLM undergoing surgical resection,including clinical risk factor score,preoperative chemotherapy response,the genetic status and the primary tumor location,and explain in detail.