直肠癌术后肝脏转移与局部转移临床病理特征和预后分析

摘要

目的:探讨直肠癌术后肝脏转移与局部转移临床病理特征和预后比较,为筛选高危患者及精准治疗提供参考.方法:回顾性分析2005-2016年485例直肠癌术后患者随访发现肝脏转移75例和局部转移32例临床及病理资料,比较术后二者临床病理特征和预后.结果:直肠癌肝脏及局部转移患者在CEA水平、肿瘤位置、手术方式、肿瘤分化程度、肿瘤浸润深度等方面的差异有统计学意义(P＜0.05).直肠癌肝脏转移的1、3和5年生存率分别为76.6％、53.1％、18.8％,局部转移的1、3、5年生存率分别为81.3％、62.5％、37.5％,(P均＜0.05).结论:直肠癌肝脏转移及局部转移其临床病理特点不同,预后存在差异,局部转移患者预后优于肝脏转移患者.%Objective:To investigate the prognosis of patients with liver metastasis or local recurrence after radical resection of rectal cancer,in order to provide reference for the further screening of high-risk patients for the precise therapeutic methods.Methods:The clinicopathological factor and follow-up data of 485 patients who underwent surgical treatment for rectal cancer from March 2005 to January 2016 were retrospectively analyzed.Including 75 liver metastasis and 32 local recurrence.The prognosis were compared between the patients with liver metastasis and with local recurrence.Results:The difference was statistically significant in CEA level,primary tumor position,surgical methods,tumor cell differentiation,tumor infiltration depth between liver metastasis and local recurrence after radical resection of rectal cancer (P＜0.05).The 1-,3-and 5-year overall survival rates were 76.6％,53.1％ and 18.8％ respectively of patients with liver metastasis,The 1-,3-and 5-year overall survival rates were 81.3％,62.5％ and 37.5％ respectively of patients with local recurrence,the difference was statistically significant(P＜0.05).Conclusion:There were different clinicopathological characteristics of patients between liver metastasis and local recurrence.The prognosis of patients with local recurrence was better than patients with liver metastasis.