Petrelli N J, Bonnheim D C, Herrera L O, Mittelman A
Dis Colon Rectum. 1984 Apr;27(4):249-52. doi: 10.1007/BF02553797.
A proposed classification system for liver metastasis from colorectal carcinoma is presented. This proposed system utilizes the prognostic factors of the extent of hepatic involvement by metastasis at the time of laparotomy, performance status, preoperative serum alkaline phosphatase level, and the presence or absence of extrahepatic intraabdominal disease at the time of laparotomy. Because of the several different modes of treatment for liver metastasis from colorectal carcinoma, it is necessary that a liver classification system be adopted so that different treatment groups will be comparable. The proposed system utilizes the extent of hepatic involvement by metastasis at laparotomy with a division into three subsets of patients described by a Roman numeral. Roman numeral I represents less than or equal to 25 per cent involvement of the liver by metastasis; Roman numeral II represents greater than 25 per cent but less than or equal to 50 per cent involvement by liver metastasis, and Roman numeral III represents greater than 50 per cent involvement by liver metastasis. An Arabic subscript number is used to describe the patients' performance status. Alkaline phosphatase levels are described by a subscript letter with a representing less than two times normal alkaline phosphatase, b representing greater than two times, but less than four times normal levels, and c representing greater than four times normal levels. At the time of laparotomy extrahepatic intra-abdominal disease is represented by the superscript letter E.
本文提出了一种用于结直肠癌肝转移的分类系统。该系统利用剖腹手术时转移灶累及肝脏的范围、身体状况、术前血清碱性磷酸酶水平以及剖腹手术时有无肝外腹腔内疾病等预后因素。由于结直肠癌肝转移有几种不同的治疗方式，因此有必要采用一种肝脏分类系统，以便不同治疗组之间具有可比性。该系统根据剖腹手术时转移灶累及肝脏的范围进行划分，将患者分为三个子集，用罗马数字表示。罗马数字I表示转移灶累及肝脏小于或等于25%；罗马数字II表示肝转移累及肝脏大于25%但小于或等于50%，罗马数字III表示肝转移累及肝脏大于50%。用阿拉伯下标数字描述患者的身体状况。碱性磷酸酶水平用下标字母表示，a表示碱性磷酸酶低于正常水平两倍，b表示高于正常水平两倍但低于四倍，c表示高于正常水平四倍。剖腹手术时肝外腹腔内疾病用上角标字母E表示。
