黄河　罗恩

[摘要] 目的 探讨青年结肠癌患者术后肝转移的危险因素。 方法 收集2002年1月～2012年12月来源于成都市第五人民医院行结肠癌根治术的青年结肠癌患者共527例，并收集其临床病理资料。采用多因素Logistic回归方法分析影响青年结肠癌患者术后发生肝转移的因素。 结果 527例青年结肠癌患者中术后肝转移的发生率为21.3%。同时，肿瘤较大者（>5 cm）会增加青年结肠癌患者术后肝转移的发生风险（OR = 5.57，95%CI：2.25～13.76）；脉管侵犯者也会增加青年结肠癌患者术后肝转移的发生风险（OR = 3.16，95%CI：1.60～6.21）；淋巴结转移是青年结肠癌患者术后发生肝转移的独立危险因素（OR = 5.25，95%CI：2.99～9.19）。 结论 肿瘤大小、脉管侵犯、淋巴结转移是影响青年结肠癌患者术后发生肝转移的主要因素，提示青年结肠癌患者发生术后肝转移与肿瘤的病理学特征存在着较为密切的关系。

[关键词] 青年；结肠癌；肝转移；危险因素

[中图分类号] R735.35 [文献标识码] A [文章编号] 1673-7210（2015）08（c）-0026-04

[Abstract] Objective To explore the risk factors of postoperative liver metastasis in young patients with colon cancer. Methods A total of 527 patients who had been conducted colorectal surgery in Chengdu Fifth People's Hospital from January 2002 to December 2012 were collected. And the clinical pathological data was collected. Multinomial Logistic regression was used to analyze the risk factors of postoperative liver metastasis in young patients with colon cancer. Results The incidence of liver metastasis after colorectal surgery of young patients with colon cancer in the 527 patients was 21.3%. Simultaneously， larger tumor size with more than 5 centimeter increased the risk of liver metastasis after colorectal surgery in young patients with colon cancer （OR = 5.57， 95%CI： 2.25-13.76）. Vascular invasion increased the risk of liver metastasis after colorectal surgery in young patients with colon cancer （OR = 3.16， 95%CI： 1.60-6.21）. Lymph node metastasis was the independent risk factor of liver metastasis after colorectal surgery in young patients with colon cancer （OR = 5.25， 95%CI： 2.99-9.19）. Conclusion Tumor size， vascular invasion， lymph node metastasis are the main factors which influence the young patients with liver metastasis of colon cancer， which reminds that the risk of liver metastasis after colorectal surgery in young patients with colon cancer is closely related to the pathological characteristics.

[Key words] Young； Colon cancer； Liver metastasis； Risk factor

结肠癌是目前较为常见的恶性肿瘤之一[1]。在我国，随着社会经济的快速发展，人们生活水平的逐步提高，人们的饮食生活方式及饮食结构也发生了较大的变化，结肠癌的发病率也在逐年上升，这给人类健康带来了较大的威胁。而在临床上，结肠癌是较易转移的癌症之一，虽然我国目前在临床上对于结肠癌患者的治疗主要是采用以手术为主、放疗和化疗为辅的综合治疗方法，但研究也表明了对于结肠癌患者的治疗效果并不是特别理想，可能是由于复发和肝转移的发生，使得结肠癌在治疗上受到了很大的局限[2-4]。研……