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目的探讨结直肠癌同时性肝转移和腹膜扩散患者的相关临床病理因素以及手术干预对其预后的影响。方法回顾性分析12年间中山大学附属第一医院肠癌数据库资料中有同时性肝转移和/或腹膜扩散患者(166例/150例)的临床病例资料及随访结果。结果在诸多病理因素中肿瘤分化程度和浆膜浸润与腹膜扩散有关(P<0.01),而肿瘤分化程度,浆膜浸润和Ducks分期等与同时性肝转移有关(P<0.01);手术不可切除的结直肠癌伴同时性肝转移组与伴腹膜扩散组的短期和长期生存率差异无统计学意义(P>0.05),而在手术可切除组中伴腹膜扩散者的长期生存率优于伴肝转移者(P<0.01)。结论结直肠癌腹膜转移患者较同时性肝转移患者长期预后好;手术不可切除的结直肠癌伴腹膜扩散或肝转移才标示着肿瘤的终末期;结直肠癌伴腹膜转移根治切除组较伴同时性肝转移根治切除组预后好,局限的结直肠癌伴腹膜转移通过手术可能得到根治。
Objective To investigate the clinical and pathological factors of patients with concurrent liver metastases and peritoneal dissemination of colorectal cancer and the effects of surgical intervention on their prognosis. Methods The clinical data and follow-up results of patients with concurrent liver metastases and / or peritoneal dissemination (166 cases / 150 cases) in the First Affiliated Hospital of Sun Yat-sen University during 12 years were retrospectively analyzed. Results The degree of tumor differentiation and serosal invasion correlated with peritoneal diffusion in many pathological factors (P <0.01), while the degree of tumor differentiation, serosal invasion and Ducks stage were related to simultaneous liver metastasis (P <0.01). The unresectable Of colorectal cancer patients with concurrent liver metastasis and peritoneal diffusion group had no significant difference between the short-term and long-term survival rates (P> 0.05), while in the resectable group with peritoneal diffusers, the long-term survival rate was better than with Liver metastasis (P <0.01). Conclusions Patients with colorectal cancer peritoneal metastasis have better long-term prognosis than patients with simultaneous liver metastasis. The patients with unresectable colorectal cancer with peritoneal diffusion or liver metastasis are the end stage of the tumor. The patients with colorectal cancer with peritoneal metastasis radical resection group Radical liver metastases radical resection group prognosis is good, limited colorectal cancer with peritoneal metastasis may be cured by surgery.