Ishizuka Mitsuru, Kita Junji, Shimoda Mitsugi, Kato Masato, Sawada Tokihiko, Kubota Keiichi
Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
Hepatogastroenterology. 2012 Jan-Feb;59(113):54-8. doi: 10.5754/hge11358.
BACKGROUND/AIMS: Few studies have investigated grading of liver metastasis (GLM) in patients with liver metastases from colorectal cancer (LM-CRC).
To screen for the most useful predictive factors in patients undergoing hepatic resection for LM-CRC, clinico-pathological factors were subjected to uni- and multivariate analyses.
One hundred and twenty-five patients were evaluated retrospectively. Univariate analyses using clinico-laboratory factors demonstrated that nomogram, gender, CRP, albumin, number of hepatic resections, liver metastasis (H) and GLM were related to postoperative death. Multivariate analysis using these seven factors disclosed that albumin (OR, 6.949; 95% CI, 1.994-24.22; p=0.002), CRP (OR, 6.977; 95% CI, 1.937-25.14; p=0.003) and GLM (OR, 2.819; 95% CI, 1.082-7.346; p=0.034) were associated with postoperative death. Kaplan-Meier analysis and log rank test revealed that higher GLM (p<0.001) and CRP (p<0.001) were associated with a higher rate of postoperative death. GLM was able to divide the patients into three independent groups with significantly different total nomogram counts (p<0.001, Kruskal-Wallis test).
GLM is able to classify patients with LM-CRC into three independent groups and offers reliable information for predicting postoperative death in such patients.
背景/目的：很少有研究调查结直肠癌肝转移（LM-CRC）患者的肝转移分级（GLM）。
为筛选接受肝切除治疗的LM-CRC患者中最有用的预测因素，对临床病理因素进行单因素和多因素分析。
对125例患者进行回顾性评估。使用临床实验室因素的单因素分析表明，列线图、性别、CRP、白蛋白、肝切除次数、肝转移（H）和GLM与术后死亡相关。使用这七个因素的多因素分析显示，白蛋白（OR，6.949；95%CI，1.994-24.22；p=0.002）、CRP（OR，6.977；95%CI，1.937-25.14；p=0.003）和GLM（OR，2.819；95%CI，1.082-7.346；p=0.034）与术后死亡相关。Kaplan-Meier分析和对数秩检验显示，较高的GLM（p<0.001）和CRP（p<0.001）与较高的术后死亡率相关。GLM能够将患者分为三个独立组，总列线图计数有显著差异（p<0.001，Kruskal-Wallis检验）。
GLM能够将LM-CRC患者分为三个独立组，并为预测此类患者的术后死亡提供可靠信息。
