Ishizawa Takeaki, Yamamoto Tetsuhisa, Sekikawa Takayoshi
First Department of Surgery, Tokyo Teishin Hospital, Tokyo, Japan.
Hepatogastroenterology. 2007 Mar;54(74):514-7.
BACKGROUND/AIMS: Some studies have shown the reduction of portal blood flow in patients with occult hepatic metastases, which may lead to a decrease in the liver volume. The aim of this study was to assess volumetric changes of the liver with occult colorectal metastases.
Sixty-three consecutive patients with colorectal cancer who underwent curative resection were studied retrospectively. The ratio of the preoperative computerized tomography (CT)-estimated liver volume to the standard liver volume (CV/SV ratio) was calculated as a uniform parameter to compare the volume between the liver with and without occult hepatic metastases.
The CT-estimated liver volume was 841 +/- 102 (mean-SD) mL in 8 patients who subsequently developed overt hepatic metastases during a 2-year follow-up and 1145 +/- 232 mL in 55 patients without metastases (p = 0.0004). The CV/SV ratio was significantly smaller in patients with metachronous hepatic metastases than in those without (0.78 +/- 0.09 versus 1.02 +/- 0.14; p < 0.0001).
The results suggest the possibility that the liver with occult colorectal metastases decreases in size before metastatic tumors develop to be detectable with conventional imaging techniques. The measurement of the CV/SV ratio may be of value in detecting occult hepatic metastases from colorectal cancer.
背景/目的：一些研究表明，隐匿性肝转移患者的门静脉血流减少，这可能导致肝脏体积减小。本研究的目的是评估隐匿性结直肠癌肝转移患者肝脏的体积变化。
回顾性研究63例接受根治性切除术的连续结直肠癌患者。计算术前计算机断层扫描（CT）估计的肝脏体积与标准肝脏体积的比值（CV/SV比值），作为比较有和无隐匿性肝转移肝脏体积的统一参数。
在2年随访期间，8例随后出现明显肝转移的患者，CT估计的肝脏体积为841±102（均值-标准差）mL，55例无转移患者的肝脏体积为1145±232 mL（p = 0.0004）。异时性肝转移患者的CV/SV比值显著低于无转移患者（0.78±0.09对1.02±0.14；p < 0.0001）。
结果提示，在转移性肿瘤发展到能用传统成像技术检测到之前，隐匿性结直肠癌肝转移的肝脏可能会缩小。CV/SV比值的测量可能对检测结直肠癌隐匿性肝转移有价值。
