Rare hepatic metastases of colorectal cancer in livers with symptomatic HBV and HCV hepatitis.
Rare hepatic metastases of colorectal cancer in livers with symptomatic HBV and HCV hepatitis.
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发表时间：
2013-05
影响因子：
0.8
通讯作者：
G. Li Destri;M. Castaing;F. Ferlito;V. Minutolo;A. Di Cataldo;S. Puleo
中科院分区：
文献类型：
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作者：
G. Li Destri;M. Castaing;F. Ferlito;V. Minutolo;A. Di Cataldo;S. Puleo
目的结直肠癌最常见的转移部位是肝脏，但在慢性肝损害患者中转移似乎较少见。本研究的目的是评估受HBV或HCV相关肝病影响的患者发生异时性肝转移的情况。研究材料我们回顾性评估了457例健康肝脏的结直肠癌根治术患者和31例受肝损害（HBV或HCV相关）影响的结直肠癌根治术患者的肝转移发展和5年无病。结果肝转移的总发生率为9%（44/488），特别是感染患者为3.2%，非感染患者为9.4%（p= 0.34）。我们的研究结果显示，感染与非感染患者的原发性结直肠癌阳性淋巴结数量和未分化癌数量之间无统计学差异（分别为29%和34.1%和9.7%和13.6%），感染患者5年无病率更高（93%和80%，p = 0.17）。讨论在感染患者中，我们登记了一个更好的粗5年无病间隔和异时性肝转移的发生率更低。这种差异与文献中提到的其他结果一致。结论结合文献报道，作者认为应考虑近年来提出的“金属蛋白酶抑制剂”致病理论。
AIM The liver is the most common site of metastases in colorectal cancer but metastases seem to be less common in patients with a chronically liver damage. The aim of our study was to assess the development of metachronous liver metastases in patients affected by HBV or HCV related liver diseases. MATERIAL OF STUDY We retrospectively evaluated above all the development of liver metastases and the 5-year disease free in 457 patients radically treated for colorectal cancer with healthy liver and in 31 patients radically treated for colorectal cancer affected by liver damage (HBV or HCV related). RESULTS Overall incidence of liver metastases was 9% (44/488), in particular 3.2% in infected patients and 9.4% in non-infected patients (p= 0.34). Our results revealed that there is no statistically significant difference between the number of positive lymph nodes of primary colorectal cancer and the number of indifferentiated cancers in infected compared with non-infected patients (29% vs 34.1% and 9.7% vs 13.6% respectively), and the 5-year disease free is better for infected patients (93% and 80%, p = 0.17). DISCUSSION In infected patients we registered a better crude 5-year disease free interval and a fewer incidence of metachronous liver metastases. This difference is in agreement with other results mentioned in literature. CONCLUSION In the light of the reported data, the authors consider that the recent pathogenetic theory of the "metalloproteinase inhibitor" should be taken in account.