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[乙型或丙型肝炎病毒感染肝脏中的结直肠癌转移]

[Colorectal carcinoma metastasis in livers infected with hepatitis B or C virus].

作者信息

Iascone C, Ruperto M, Barillari P

机构信息

Dipartimento di Chirurgia, Pietro Valdoni, Università degli Studi di Roma, La Sapienza, Roma, Italy.

出版信息

Minerva Chir. 2005 Apr;60(2):77-81.

Abstract

AIM

Metastases from colorectal cancers rarely occur in injured livers, however in western countries this phenomenon has not been investigated in patients with various forms of chronic hepatitis. Therefore in this study we evaluated the incidence of synchronous hepatic metastases of colorectal carcinomas in patients with hepatitis B (HBV) or C (HBC) infection.

METHODS

Six hundred and thirty patients undergoing surgical treatment for colorectal carcinomas were analysed: the clinicopathological data of 87 patients with HBV or HCV infection (there were 29 patients with hepatitis C infection and 58 with hepatitis B infection) were compared to those of 543 non infected patients.

RESULTS

Patients distribution was similar in both groups in terms of gender, age, type of operative procedures performed, histological grading and lymph node metastases. Stage I, II or III tumours were similarly represented in non infected and infected patients, while stage IV tumours were 33.1% in the non infection group and 17.2% in the infection group (P < 0.001). At the time of surgery, synchronous extrahepatic metastases were present in 14.9% of non infected patients and 15% of infected patients, while synchronous hepatic metastases were found in 32% and 17.2% of patients respectively (P < 0.01).

CONCLUSIONS

Results of our study show that synchronous hepatic metastases of colorectal cancers are less frequently observed in chronic HBV or HCV infected patients than in non infected patients, while the incidence of extrahepatic metastases is comparable in both groups, suggesting that virus-related mechanisms and specific liver mediated immunity may have a protective role against neoplastic cell colonization of the liver.

摘要

目的

结直肠癌转移很少发生在受损肝脏,然而在西方国家,尚未对患有各种形式慢性肝炎的患者进行过此类现象的研究。因此,在本研究中,我们评估了乙型肝炎(HBV)或丙型肝炎(HBC)感染患者中结直肠癌同步肝转移的发生率。

方法

分析了630例接受结直肠癌手术治疗的患者:将87例HBV或HCV感染患者(其中29例为丙型肝炎感染患者,58例为乙型肝炎感染患者)的临床病理数据与543例未感染患者的临床病理数据进行比较。

结果

两组患者在性别、年龄、手术方式、组织学分级和淋巴结转移方面分布相似。非感染患者和感染患者中I、II或III期肿瘤的比例相似,而IV期肿瘤在非感染组中为33.1%,在感染组中为17.2%(P<0.001)。手术时,非感染患者中有14.9%存在同步肝外转移,感染患者中有15%存在同步肝外转移,而同步肝转移分别在32%和17.2%的患者中发现(P<0.01)。

结论

我们的研究结果表明,与未感染患者相比,慢性HBV或HCV感染患者中结直肠癌同步肝转移的发生率较低,而两组肝外转移的发生率相当,这表明病毒相关机制和特定的肝脏介导免疫可能对肝脏肿瘤细胞定植具有保护作用。

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