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目的回顾性观察有、无脂肪肝的大肠癌(CRC)患者肝转移发生的差异,分析脂肪肝对CRC肝转移的可能影响。方法经结肠镜与病理和/或手术诊断的CRC患者326例,其中肝转移70例,脂肪肝55例。配对比较设计:根据CRC患者中脂肪肝的检出例数,以1∶2的比例确定非脂肪肝组,按年龄、性别及病情尽量匹配的原则确定,然后对其肝转移和非肝转移的检出率分别进行比较。结果非配对CRC的比较中,有脂肪肝的患者肝转移的发生率为9.1%,显著低于无脂肪肝组的24.0%(P<0.01),而非肝脏转移发生率比较差异无统计学意义。在配对大肠癌的比较中,上述差异仍然存在,有脂肪肝的患者肝转移的发生率显著低于无脂肪肝组(P<0.01),非肝脏转移发生率比较差异仍无统计学意义。结论CRC患者有脂肪肝时发生肝转移的比例明显低于无脂肪肝者,其发生机制及临床意义有待于进一步探讨。
Objective To retrospectively observe the difference of liver metastases in patients with and without fatty liver and to analyze the possible effect of fatty liver on the metastasis of CRC. Methods 326 cases of CRC diagnosed by colonoscopy, pathology and / or surgery were diagnosed as liver metastasis in 70 cases and fatty liver in 55 cases. Comparative design: according to the number of cases of fatty liver detected in patients with CRC, to determine the ratio of 1: 2 non-fatty liver group, according to age, gender and condition as far as possible matching principle to determine, and then its liver metastasis and non-liver metastasis The detection rates were compared. Results In unpaired CRC, the incidence of hepatic metastases in patients with fatty liver was 9.1%, which was significantly lower than that in non-steatohepatitis (24.0%, P <0.01), while there was no significant difference in non-hepatic metastasis . In the paired colorectal cancer comparison, the above differences still existed. The incidence of hepatic metastasis in patients with fatty liver was significantly lower than that in non-steatohepatitis (P <0.01). The incidence of non-hepatic metastasis was still not statistically significant. Conclusion The proportion of hepatic metastasis in patients with fatty liver is significantly lower than that in patients without fatty liver, and the mechanism and clinical significance need to be further explored.