【摘要】 目的分析可切除直肠癌肺转移的临床特点及异时性肺转移发生率的影响因素。方法回顾性分析2007年1月至2014年12月中国科学院大学附属肿瘤医院收治的直肠癌肺转移并接受胸腔镜辅助下手术切除患者的临床资料,对患者的临床病理特征进行统计分析。结果根据纳入及排除标准共筛选出75例患者作为研究对象,其中术前即存在同时性肺转移11例,术后发生异时性肺转移64例。肺转移患者中52例(69.3%)接受胸腔镜辅助下肺楔形切除术,4例(5.3%)接受肺段切除术,19例(25.3%)接受肺叶切除术。在根治性手术后5年内,T3/4患者较T1/2患者异时性肺转移发生率更高(P<0.05),而在不同年龄、性别、手术方式、淋巴结转移状态、术前新辅助放化疗、术后辅助放疗、术后辅助化疗的亚组分析中异时性肺转移发生率差异均无统计学意义(均P>0.05)。结论胸腔镜辅助下肺楔形切除术是可切除直肠癌肺转移最为常用的手术方式,肿瘤T分期较晚者术后5年内异时性肺转移发生率更高。更多还原

【Abstract】 Objectives To analyze the clinicopathologic features of resectable lung metastasis of rectal cancer, and the influencing factors on the incidence of heterochronous lung metastasis. Methods This was a retrospective analysis of patients who underwent thoracoscopic assisted pulmonary resection for rectal cancer lung metastasis during January 2007 and December 2014 at Cancer Hospital Affiliated to the University of Chinese Academy of Sciences. Results A total of 75 patients fulfilled the inclusion criteria, 11 had synchronous lung metastasis before surgery, and 64 had metachronous lung metastasis after surgery. Fiftytwo(69.3%) patients underwent thoracoscopic assisted pulmonary wedge resection, 4(5.3%) underwent pulmonary segmentectomy,and 19(25.3%) underwent lobectomy. Within five years after surgery, T3/4 patients were more likely to have metachronous lung metastasis than T1/2 patients(P<0.05). Subgroup analyses showed that age, sex, surgical approach, lymph node status, neoadjuvant chemoradiation, adjuvant radiotherapy, adjuvant chemotherapy did not affect the incidence of metachronous lung metastasis(P>0.05). Conclusion Thoracoscopic assisted pulmonary wedge resection is the most common approach for rectal cancer lung metastasis. The incidence of metachronous lung metastasis within five years is higher in patients with a late T stage.更多还原