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頁籤選單縮合
題名 | Chronic Viral Hepatitis and Colorectal Cancer Related Liver Metastasis--A Single Institute Experience=肝炎和大腸直腸癌肝臟轉移之間的關係 |
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作者 | 廖育唯; 范仲維; 游彥麟; 曾文科; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 29:2 2018.06[民107.06] |
頁次 | 頁100-105 |
分類號 | 416.24 |
關鍵詞 | 大腸直腸癌; 慢性肝炎; B型肝炎; C型肝炎; 肝臟轉移; Chronic hepatitis; Hepatitis C virus; Hepatitis B virus; Colorectal cancer; Liver; Metastasis; |
語文 | 英文(English) |
中文摘要 | 目的:在大腸直腸癌的病人中,有慢性肝炎的病人在之前的研究中顯示較低的機會發生肝臟轉移。但在最近的全國性研究發現,慢性肝炎合併肝硬化的這群病人反而有較高的機會發生肝臟轉移。我們的研究想要探討慢性肝炎和大腸直腸癌肝臟轉移的關係。方法:我們統計了2006年1月至2015年12月565位在基隆長庚醫院診斷為大腸直腸癌併接受治療的病人。我們回顧性收集了病人的病歷資料,包括影像、病歷、實驗室檢查。HBsAg陽性及Anti-HCV陽性的病人被定義為慢性肝炎。Chi square test和Student t test被用於比較兩組的基本資料和發生肝臟轉移的風險。Kaplan-Meier method被用於存活分析併使用log-rank test比較兩組。結果:所有的病人中,實驗組的54位是被定義為慢性肝炎,其餘464位則是無慢性肝炎。有104位病人發生肝臟轉移,包括82位診斷時就發生肝臟轉移,以及22位在追蹤過程中發現肝臟轉移。兩組病人在診斷時發生肝臟轉移的機率無顯著差異,慢性肝炎的病人在追蹤過程中有較高的機會發生肝臟轉移。兩組的病人的存活率無差異。結論:慢性肝炎對大腸直腸癌的肝臟轉移以及存活率並無顯著的影響。在追蹤的過程中可能有較高的機會發生肝臟轉移。兩組的存活率沒有差異。 |
英文摘要 | Purpose. The rarity of the occurrence of metastatic malignancy in injured liver has been noticed. However, recent study showed that patients with liver cirrhosis related to both HBV and HCV infections have highest risk of liver metastasis. Thus, we designed this study to review the relation between HBV infection and liver metastasis of CRC. Material and Method. A total of 565 CRC patients admitted to Chang Gung Memorial Hospital Keelung branch from January 2006 to December 2015 were recruited in this study. Patient with laboratory test of HBsAg positive and Anti-HCV positive were defined as patient with chronic hepatitis. Differences in demographic data and rate of liver metastasis between the two groups were compared by chi square test or Student t test. Overall survival (OS) and cumulative risk for liver metastasis curves were plotted with the Kaplan-Meier method, and compared by log-rank test. Result. Liver metastasis occurred in 104 patients including synchronous liver metastasis in 82 cases and metachronous liver metastasis in 22 cases. There is no significant difference in the incidence of liver metastasis between the study group and the control group (25.9% vs. 19.4%, p = 0.257). There is no significant difference in the incidence of synchronous liver metastasis (18.4% vs. 16.3%, p = 0.716). Patients with chronic hepatitis had significantly higher risk for developing metachronous liver metastasis (11.1% vs. 4.3%, p value of log rank test = 0.044). There is no significant difference found in overall survival. Conclusion. Chronic hepatitis infection did not have significant influence on incidence of liver metastasis in CRC patients. Patient with chronic hepatitis may have a tendency to have higher risk of developing metachronous liver metastasis. No difference were found in overall survival between the two groups. |
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