影响结直肠癌肝转移患者预后的临床病理因素分析

摘要/Abstract

摘要： 目的：分析影响结直肠癌肝转移（colorectal liver metastases, CRLM）患者预后的临床病理因素。
方法：回顾性分析2014年3月至2016年3月北京大学第三医院收治的同时性CRLM患者。收集患者相关临床、原发灶、肝转移灶病理等资料,并进行随访。通过单因素分析及Cox回归分析CRLM患者预后的影响。
结果：本研究共纳入97例CRLM患者,其中男性57例,女性40例,平均年龄（61.2±11.8）岁,肿瘤位于右半结肠54例,左半结直肠共43例。单因素分析结果显示,术前癌胚抗原（carcinoembryonic antigen, CEA）>32 ng/ml、术前糖类抗原19-9（carbohydrate antigen19-9, CA19-9）>20 U/ml、有癌结节、术后N分期、原发肿瘤位于右半结肠、肝转移灶数目>3个、原发肿瘤低分化是影响CRLM患者术后3年总生存率的非独立危险因素（P均<0.05）。采用Cox回归模型进行多因素分析,结果显示术前CEA水平[风险比（hazard ratio, HR）=2.123,95% 置信区间（95% confidence interval, 95%CI）：1.151~3.918]、术前CA19-9水平（HR=2.022,95%CI：1.094~3.738）、原发肿瘤位置（HR= 0.502,95%CI：0.265~0.951）、原发肿瘤分化程度（HR= 0.519,95%CI：0.300~0.899）为影响CRLM患者预后的独立危险因素。
结论：原发肿瘤位于右半结肠、原发肿瘤低分化、术前CEA>32 ng/ml、术前CA19-9>20 U/ml是影响CRLM患者预后的独立危险因素。

关键词: 结直肠癌肝转移, 预后, 影响因素

Abstract: Objective: To investigate the clinical and pathological factors affecting the prognosis of patients with colorectal liver metastases (CRLM) patients.
Method: Patients with synchronous CRLM who were admitted to Peking University Third Hospital from March 2014 to March 2016 were retrospectively analyzed. The relevant clinical data, pathology of primary tumor and liver metastases of each patient were collected, and the patients were followed up. Univariate analysis and Cox regression were used to analyze the independent prognostic factors of CRLM.
Result: A total of 97 patients with CRLM were included in this study, including 57 males and 40 females, with an average age of (61.2±11.8) years, 54 cases in the right colon and 43 cases in the left colon and rectum. Univariate analysis showed that preoperative carcinoembryonic antigen (CEA)>32 ng/ml, preoperative carbohydrate antigen19-9 (CA19-9)>20 U/ml, presence of cancer nodules, postoperative N stage, primary tumor located in the right hemicolon, the number of liver metastases>3, and poor differentiation of the primary tumor were non-independent risk factors affecting the 3-year overall survival of patients (all P<0.05). Cox regression model was used for multivariate analysis, the results showed that preoperative CEA level (hazard ratio [HR]=2.123, 95% confidence interval [95%CI]: 1.151-3.918), preoperative CA19-9 level (HR=2.022, 95%CI: 1.094-3.738), primary tumor location (HR=0.502, 95%CI: 0.265-0.951) and tumor differentiation (HR=0.519, 95%CI: 0.300-0.899) were independent risk factors for prognosis.
Conclusion: The primary tumor located in the right hemicolon, the primary tumor poorly differentiated, the preoperative CEA >32 ng/ml, and the preoperative CA19-9 >20 U/ml are independent risk factors affecting the prognosis of patients with CRLM.

Key words: Colorectal liver metastasis, Prognosis, Influence factors

王朋, 杜俊东, 王行雁, 修典荣. 影响结直肠癌肝转移患者预后的临床病理因素分析[J]. 肝癌电子杂志, 2024, 11(2): 43-47.

Wang Peng, Du Jundong, Wang Hangyan, Xiu Dianrong. Clinical and pathological factors affecting the prognosis of patients with colorectal liver metastasis[J]. Electronic Journal of Liver Tumor, 2024, 11(2): 43-47.

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