原发肿瘤部位、术前CEA水平及Dukes分期与结直肠癌术后肺转移的相关性研究

摘要

Objective Correlation of primary tumor location, preoperative CEA level and Dukes stage with lung metastasis after colorectal cancer surgery. Methods Randomly selected 73 cases after colorectal cancer surgery and analyze the clinicopathological characteristics of the patients. Results 30 cases of simple lung metastasis patients, the location of primary metastasis of lung metastases was related to lung metastasis. Twenty-one patients had rectal cancer, nine had colon cancer, 18 had unilateral lung metastases, and 12 had bilateral lung metastases. The time of primary tumor operation to lung metastasis was 2 ～ 39 months, with a median time of (11.7 ± 3.6) months. The incidence of lung metastasis in patients with the location of primary tumor, lymph node metastasis, preoperative CEA level (＞ 5 μg/L) and Dukes stage C was significantly higher than that in patients without lymph node metastasis, preoperative CEA level ＜ 5 μg/L and Dukes stage B (P ＜ 0.05). However, there was no significant difference in the size of tumor, the pathological type of primary tumor, the number of lymph node dissection and the incidence of pulmonary metastasis in patients with vascular invasion (P＞ 0.05). Multivariate logistic regression analysis showed that the risk factors of lung metastasis included the location of primary tumor, preoperative CEA level and Dukes stage (P ＜ 0.05), but not lymph node metastasis (P＞ 0.05). Conclusion The location of primary tumor, preoperative CEA level and Dukes stage were significantly correlated with lung metastasis after colorectal cancer surgery.%目的 研究原发肿瘤部位、术前CEA水平及Dukes分期与结直肠癌术后肺转移的相关性.方法 随机选取术后结直肠癌患者73例,对患者的不同临床病理特征进行统计分析.结果 单纯性肺转移30例,肺转移原发肿瘤部位:21例患者为直肠癌,9例患者为结肠癌;在肺转移部位方面,18例患者为单侧,12例患者为双侧.原发肿瘤手术到肺转移确诊时间在2～39个月之间,中位时间为 (11.7±3.6) 个月.原发肿瘤部位、淋巴结转移、术前CEA水平≥5μg/L、Dukes分期C期患者的肺转移发生率均显著高于无淋巴结转移、术前CEA水平＜5μg/L、Dukes分期B期患者 (P ＜0.05);不同肿瘤大小、原发灶病理类型、淋巴结清扫数目、脉管浸润患者的肺转移发生率之间的差异无统计学意义 (P＞0.05).多因素Logistic回归分析模型分析结果表明,肺转移危险因素包括原发肿瘤部位、术前CEA水平、Dukes分期 (P＜0.05),但不包括淋巴结转移 (P＞ 0.05).结论 原发肿瘤部位、术前CEA水平及Dukes分期与结直肠癌术后肺转移显著相关.