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占位性病变引起的肝功能异常与结直肠癌肝转移患者的不良肿瘤预后相关。

Abnormal Liver Function Induced by Space-Occupying Lesions Is Associated with Unfavorable Oncologic Outcome in Patients with Colorectal Cancer Liver Metastases.

机构信息

Department of Colorectal Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.

Department of Thoracic Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.

出版信息

Biomed Res Int. 2018 May 15;2018:9321270. doi: 10.1155/2018/9321270. eCollection 2018.

Abstract

An early prediction of prognosis for patients with colorectal liver metastasis (CRLM) may help us determine treatment strategies. Liver function reflects the effect of the overall metastatic burden. We investigated the prognostic value of liver function in CRLM patients. In our study, patients with abnormal LFTs (liver function tests) had a poorer prognosis than did those with normal LFTs ( < 0.05). A multivariate analysis revealed that LFTs was an independent prognostic factor for CRLM. For those patients with abnormal LFTs, novel prognostic contour maps were generated using LFTs, and no positive correlation exists between the values of survival duration and abnormal LFTs. Additionally, the MTVR (metastatic tumor volume ratio) was measured directly by magnetic resonance imaging and was shown to be highly correlated to LFTs by a Pearson correlation analysis. A multivariate logistic regression analysis also demonstrated that the MTVR and hepatectomy were independently predictive of abnormal LFTs. The space-occupying effect of metastatic lesions can cause abnormal LFTs, resulting in a poor prognosis. Biochemical analyses of LFTs at the initial diagnosis of CRLM enable the stratification of patients into low- and high-risk groups; it may help clinicians determine promising treatment strategies.

摘要

早期预测结直肠癌肝转移(CRLM)患者的预后情况有助于我们确定治疗策略。肝功能反映了整体转移负担的影响。我们研究了肝功能在 CRLM 患者预后中的预测价值。在我们的研究中,肝功能异常(LFTs)的患者预后比肝功能正常(LFTs < 0.05)的患者差。多变量分析显示,LFTs 是 CRLM 的独立预后因素。对于那些肝功能异常的患者,使用 LFTs 生成了新的预后轮廓图,并且生存时间的数值与异常的 LFTs 之间没有正相关关系。此外,通过磁共振成像直接测量 MTVR(转移瘤体积比),并通过 Pearson 相关分析显示与 LFTs 高度相关。多变量逻辑回归分析还表明,MTVR 和肝切除术是异常 LFTs 的独立预测因素。转移病灶的占位效应会导致 LFTs 异常,从而导致预后不良。在 CRLM 初始诊断时对 LFTs 进行生化分析,可以将患者分为低危和高危组;这可能有助于临床医生确定有前途的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2df0/5976940/fbdccf79c360/BMRI2018-9321270.001.jpg

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