【摘要】：背景:結(jié)直腸癌肝轉(zhuǎn)移患者肝切除術(shù)后的復(fù)發(fā)是影響患者總體生存的重要原因。在肝切除術(shù)后2年內(nèi),超過(guò)一半的患者將會(huì)復(fù)發(fā)。其中大部分是在術(shù)后6月內(nèi)復(fù)發(fā),傳統(tǒng)上稱為早期復(fù)發(fā);最新的研究認(rèn)為將早期復(fù)發(fā)的時(shí)間定義為8個(gè)月更為合理。本研究分析初始可切除的結(jié)直腸癌肝轉(zhuǎn)移術(shù)后早期復(fù)發(fā)的危險(xiǎn)因素。方法:回顧性分析浙江大學(xué)附屬第二醫(yī)院自2007年2月至2016年5月收治的90例患結(jié)直腸癌肝轉(zhuǎn)移,肝臟轉(zhuǎn)移灶經(jīng)評(píng)估為初始可切除并且接受轉(zhuǎn)移灶切除術(shù)的患者。收集臨床資料,單因素分析用t檢驗(yàn)與χ2檢驗(yàn),多因素分析使用logistic回歸分析;非正態(tài)分布資料用Wilcoxon秩和檢驗(yàn);COX回歸分析繪制RFS曲線。結(jié)果:單因素分析結(jié)果顯示:CA199200ng/ml、肝臟轉(zhuǎn)移灶數(shù)目≥3個(gè)與CRLM患者早期復(fù)發(fā)有關(guān)(P0.05)�；颊叩男詣e、年齡、原發(fā)灶的部位、T分期、淋巴結(jié)轉(zhuǎn)移、術(shù)前CEA水平、肝轉(zhuǎn)移是否分布肝兩葉、轉(zhuǎn)移灶最大徑是否≥5cm、同時(shí)性肝轉(zhuǎn)移還是異時(shí)性肝轉(zhuǎn)移、是否行新輔助化療、術(shù)前化療評(píng)估、是否術(shù)中B超探查、是否聯(lián)合術(shù)中射頻均與其早期復(fù)發(fā)無(wú)相關(guān)(P0.05)。結(jié)論:將早期復(fù)發(fā)的時(shí)間定義為8個(gè)月的前提下,CA199200ng/ml、肝臟轉(zhuǎn)移灶數(shù)目≥3個(gè)是初始可切除的結(jié)直腸癌肝轉(zhuǎn)移術(shù)后早期復(fù)發(fā)的危險(xiǎn)因素,并且是獨(dú)立危險(xiǎn)因素。
[Abstract]:Background: recurrence after hepatectomy in patients with liver metastases from colorectal cancer is an important cause of overall survival. Within 2 years after hepatectomy, more than half of the patients will recur. Most of them recrudesce within 6 months after operation, which is traditionally called early recurrence. The latest study suggests that it is more reasonable to define the time of early recurrence as 8 months. This study analyzed the risk factors for early recurrence of liver metastases from colorectal cancer with initial resectability. Methods: 90 patients with liver metastasis from February 2007 to May 2016 in the second affiliated Hospital of Zhejiang University were retrospectively analyzed. The liver metastases were evaluated as initially resectable and resected. Clinical data were collected. T test and 蠂 2 test were used for univariate analysis, logistic regression analysis was used for multivariate analysis, and RFS curve was drawn by Wilcoxon rank sum test Cox regression analysis for non-normal distribution data. Results: univariate analysis showed that the number of liver metastases 鈮，

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