何翠瑛++苏贞栋++陈燕红

[摘要] 结直肠癌是消化系统高发病率的一种恶性肿瘤。在全球范围内，结直肠癌每年约有130万的新发病例，69万死亡病例，发病率仅次于肺癌和乳腺癌，位居恶性肿瘤发病第3位，是世界男性第3位，女性第2位高发的恶性肿瘤。在我国，其发病率已居恶性肿瘤的第3位，病死率位居恶性肿瘤第5位。近年来因为饮食习惯的改变、老年人口的增加致使结直肠癌的患病率呈不断升高趋势，结直肠癌已经成为我国最多见的消化道恶性肿瘤之一。临床研究发现，肝脏又是结直肠癌血行转移最常见位置。结直肠癌肝转移是临床上治疗的重点及难点，为了更好的治疗结直肠癌肝转移，现就对结直肠癌肝转移新辅助化疗中出现的相关问题（结直肠癌肝转移诊断、新辅助化疗的功能及临床应用、新辅助化疗相关的肝损伤及对手术的影响以及新辅助化疗周期数和药物选择）进行研究分析。

[关键词] 结直肠癌；肝转移；新辅助化疗；相关问题

[中图分类号] R735 [文献标识码] A [文章编号] 1674-0742（2017）05（a）-0190-03

[Abstract] Colorectal cancer is a malignant tumor with high morbidity of digestive system， in the global range， there are 1，300，000 new cases and 690，000 death cases every year， and the morbidity is only superior to the lung cancer and breast cancer， ranking the third for male and second for female， in China， the morbidity ranks the third and the morality ranks the fifth， in recent years， the changes of dieting habits and increase of senile population lead to the ever-increasing morbidity of colorectal cancer， and the colorectal cancer has already been one of the most common digestive tract malignant tumors， the clinical research shows that the liver is the most common site of hematogenous metastasis of colorectal cancer， and the metastasis of colorectal cancer is the clinical treatment key points and difficult points， in order to better treat the metastasis of colorectal cancer， now the paper researches and analyzes the related problems of metastasis and diagnosis of colorectal cancer， function and clinical application of new adjuvant chemotherapy， related liver injury of new adjuvant chemotherapy and effect on operation and periodicity and drug selection of new adjuvant chemotherapy.

[Key words] Colorectal cancer； Liver metastasis； New adjuvant chemotherapy； Related problem

結直肠癌位居胃肠道肿瘤发病率第2位，常见消化系统恶性肿瘤。60%左右的结直肠癌病变发生在直肠与乙状结肠的交界处[1-2]。且中年男性比中年女性好发（2：1）。结直肠癌早期症状并不明显，容易被忽视。目前，尚没有统一的标准划分高龄结直肠癌患者的年龄，但我国多以70岁作为分界线。根据文献调查，我国70岁以上高龄结直肠癌患者数量约占结直肠癌患者总数的10%～20%。结……