消化道肿瘤肝脏转移的临床病理学分析(附55例报告)

CLINICOPATHOLOGIC ANALYSIS OF 55 LIVER METASTATIC TUMORS FROM GASTROENTROLOGIC TRACT

作者对55例消化道肿瘤肝脏转移的病理学特征进行了分析。其结果表明:(1)55例消化道肿瘤转移肝脏的有38例(69.1％)来自结肠,证明结肠肿瘤大部分是由门静脉血流转移至肝脏;(2)55例病人血清学检查中CEA升高的有35例(63.5％),提示:CEA是辅助诊断消化道肿瘤转移的有用指标;(3)B超、CT和MRI是探测消化道肿瘤转移肝脏的非常有益的手段,(4)55例病人血清中AFP检测均为阴性,而术中病人肝脏均无肝硬变改变;这表明与原发性肝癌不同;(5)外科手术治疗仍然是消化道肿瘤肝脏转移的最佳方法,本组病人中有48例患者进行再手术切除,术后患者最长的已生存9年。

Clinicopathologic features of liver metastatic tumors from gastronentrologic tract was studied Surgical resected fifty-five cases of liver metastatic malignant cancers from gastroenterologic tract were analyzed. It was found that (1) of 38 cases (69. 1 %) in the total of 55 metastatic tumors were originated from colon, meaning that colon tumors most likely to be metastases to the liver through portal vein; (2) The elevation of serum CEA was found in 63. 5% cases, suggesting that detection of surem CEA was useful in diagnosis of the liver metastatic tumors from gastroenterologic tumor; (3) B-ultrasond, CT and MRI were al-so useful for the detection of the liver metastatic cancer; (4) None of 55 cases was found elther positive serum AFP or liver cir-rhosis , which were different from primary liver cell cancer; (5) Surgical resection should be the first choice for the treatment of liver metastatic cancer. In this group reoperation was carried out in 48 cases (87. 5%), the longest postoperative surivival times was 9 years.