Li Destri Giovanni, Castaing Marine, Ferlito Francesca, Minutolo Vincenzo, Di Cataldo Antonio, Puleo Stefano
Ann Ital Chir. 2013 May-Jun;84(3):323-7.
The liver is the most common site of metastases in colorectal cancer but metastases seem to be less common in patients with a chronically liver damage. The aim of our study was to assess the development of metachronous liver metastases in patients affected by HBV or HCV related liver diseases.
We retrospectively evaluated above all the development of liver metastases and the 5-year disease free in 457 patients radically treated for colorectal cancer with healthy liver and in 31 patients radically treated for colorectal cancer affected by liver damage (HBV or HCV related).
Overall incidence of liver metastases was 9% (44/488), in particular 3.2% in infected patients and 9.4% in non-infected patients (p= 0.34). Our results revealed that there is no statistically significant difference between the number of positive lymph nodes of primary colorectal cancer and the number of indifferentiated cancers in infected compared with non-infected patients (29% vs 34.1% and 9.7% vs 13.6% respectively), and the 5-year disease free is better for infected patients (93% and 80%, p = 0.17).
In infected patients we registered a better crude 5-year disease free interval and a fewer incidence of metachronous liver metastases. This difference is in agreement with other results mentioned in literature.
In the light of the reported data, the authors consider that the recent pathogenetic theory of the "metalloproteinase inhibitor" should be taken in account.
肝脏是结直肠癌最常见的转移部位,但在慢性肝损伤患者中转移似乎不太常见。我们研究的目的是评估受乙肝或丙肝相关肝病影响的患者异时性肝转移的发生情况。
我们回顾性评估了457例肝脏健康的接受根治性治疗的结直肠癌患者以及31例受肝损伤(乙肝或丙肝相关)影响的接受根治性治疗的结直肠癌患者的肝转移发生情况及5年无病生存期。
肝转移的总体发生率为9%(44/488),其中感染患者为3.2%,未感染患者为9.4%(p = 0.34)。我们的结果显示,与未感染患者相比,感染患者原发性结直肠癌阳性淋巴结数量和低分化癌数量之间无统计学显著差异(分别为29%对34.1%和9.7%对13.6%),且感染患者的5年无病生存期更好(93%和80%,p = 0.17)。
在感染患者中,我们记录到较好的5年粗无病间期和较低的异时性肝转移发生率。这一差异与文献中提到的其他结果一致。
根据所报告的数据,作者认为应考虑“金属蛋白酶抑制剂”这一最新的发病机制理论。