摘要
目的分析大肠癌同期肝转移的相关临床危险因素。方法回顾性分析85例大肠癌患者的临床资料,其中发生同期肝转移19例。所有患者术前均行计算机断层扫描（CT）、腹部B超及结肠镜检查,检测血清甲胎蛋白（AFP）、血清癌胚抗原（CEA）及乙型肝炎病毒表面抗原（HBsAg）水平,观察患者有无肝转移及转移灶的部位、数量及大小。结果术前同时应用B超和CT检查对于直径大于1 cm病灶的检测率显著高于单独使用CT或B超的检测率;左半结肠癌发生同期肝转移较多;有原发灶周围淋巴结者肝转移发生率显著高于未出现周围淋巴结转移者;血清CEA〈5μg/L者同期肝转移发生率显著低于血清CEA 5~15μg/L及CEA〉15μg/L者。结论肝硬化、原发灶周围淋巴结转移及血清CEA水平是影响大肠癌同期肝转移的重要危险因素,而术前CT联合腹部B超检查及血清CEA水平的检测是肝转移诊断的重要方法。
Objective To analyze the clinical risk factors related to liver metastasis synchronized with colorectal cancer.Methods The clinical data of 85 patients with colorectal cancer were analyzed.Nineteen patients suffered from liver metastasis synchronized with colorectal cancer.Computed tomography（CT）,B ultrosonography and colonoscopy were performed on all patients.The levels of serum alpha-fetoprotein（AFP）,carcino embryonie antigen（CEA） and hepatitis B surface antigen（HBsAg） were detected,and the condition of liver metastasis was observed,including metastatic parts,quantity and size.Results Before operation,the detection rate of B ultrosonography and CT to the lesion with diameter more than 1 cm was significantly higher than that of CT or B ultrosonography alone;liver metastasis occurred more in left colonic carcinoma,which might be related to its growth pattern;the incidence of liver metastasis in patients with peripheral lymph nodes in primary tumor was obviously higher than that in patients without peripheral lymph nodes in primary tumor;the incidence of liver metastasis in patients with serum CEA5 μg/L was also lower than that in patients with CEA 5-15 μg/L and 15 μg/L.Conclusion Cirrhosis,peripheral lymph node metastasis in primary tumor and serum CEA level are important risk factors of liver metastasis synchronized with colorectal cancer,but CT combined with B ultrosonography and detection of serum CEA level are important methods to diagnose liver metastasis.
出处
《实用临床医药杂志》
CAS
2013年第11期47-49,共3页
Journal of Clinical Medicine in Practice
基金
中国高校医学期刊临床专项资金(11320115)
关键词
大肠癌
同期
肝转移
危险因素
colorectal cancer
synchronization
liver metastasis
risk factors
