- 期刊
Prognostic Factors of Early Metastasis in Stage III Colorectal Cancer
第III期大腸直腸癌早期轉移預測因子分析
摘要
目的：在第3期大腸直腸癌患者長期追蹤中，醫學文獻報導的轉移比率為30.8%。臨床上有少數病人在手術後6個月內即發生遠端轉移的情況。我們試圖找出可能影響此現象的因素以及對之後預後的影響。方法：由成大醫院癌症中心的數據庫中，我們找出一開始病理分期第三期並且手術之後有轉移的病人。分析他們的相關資料試圖找出預測因子。結果：從2004年五月到2011年12月，在604個第3期患者當中有45例患者被收案，其平均術後追蹤時間為40.3個月。我們發現不管是年齡、性別、原發病灶的位置、UICC分期、k-ras基因突變、轉移淋巴結數目、轉移淋巴結比率或術後輔助化療都對轉移時間都沒有影響。但是在早期轉移的病人中，患者有較高的術後癌胚胎抗原(CEA)數值以及術後較少癌胚胎抗原下降幅度。是否早期轉移在存活期間和轉移後的生存時間並無統計上的差異。結論：我們發現較高的術後癌胚胎抗原數值以及術後癌胚胎抗原較少降低幅度均是早期轉移的預測因子。
並列摘要
Purpose. The metastasis rate of stage III colorectal cancer (CRC) was 30.8%. We noted that few patients had metastasis within 6 months postoperation. We investigatedthe possible prognostic factors and influencesonsurvival. Methods. We searched the databank ofthe National Cheng Kung University Hospital Cancer Center from May 2004 to December 2011. Initial pathological stage III CRC was identified through a review of medical records. In the metastasis group, we analyzed the perioperative factors and the outcome. Results. Forty-five patients with initial pathological stage III CRC who developed metastasis were recruited. The mean follow-up duration was 40.3 months. We did not find a significantdifference in the age, sex, primary lesion location, Unionfor International Cancer Control stage, k-ras mutant, metastatic lymph node number, lymph node ratio, oradjuvant chemotherapy. In the early metastasis group, patients had a higher postoperativecarcinoembryonic antigen (CEA) level and a smaller CEA reduction after operation. The overall survival and life span after metastasis did not differ significantly. Conclusion. A higher postoperative serum CEA level and a smaller CEA reduction after operation were the prognostic factors of early metastasis.
參考文獻
延伸閱讀
- Wu, C. C., Wang, J. H., King, T. M., Chang, M. C., & Hsu, C. W. (2014). 第三期大腸直腸癌之橫向腫瘤大小為臨床預後之反向預測因子. 中華民國大腸直腸外科醫學會雜誌, 25(3), 65-73. https://doi.org/10.6312/SCRSTW.2014.25(3).10306
- 蔡祥麟（2016）。大腸直腸癌病人根除性切除手術後預後因子與轉移性大腸直腸癌病人預測因子研究〔博士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-2411201610422000
- 張秋純（2018）。大腸直腸癌K-ras突變基因影響臨床預後之機轉研究〔博士論文，中山醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0003-1202201816461400
- Han, L. S., Ho, C. H., Jen, L. C., Tian, Y. F., & Chou, C. L. (2017). 分析以不同的起始方式治療大腸直腸癌併肝轉移的預後. 中華民國大腸直腸外科醫學會雜誌, 28(4), 191-200. https://doi.org/10.6312/SCRSTW.2017.28(4).10617
- Lai, I. L., Hsu, Y. J., Chern, Y. J., You, J. F., Tsai, W. S., Hsieh, P. S., Hung, H. Y., & Chiang, J. M. (2019). 早期中低位直腸癌術後局部復發及遠端轉移之危險因子分析. 中華民國大腸直腸外科醫學會雜誌, 30(3), 117-126. https://doi.org/10.6312/SCRSTW.201909_30(3).10814