目的 分析影响同时性与异时性结肠直肠癌(CRLM)肝内微转移的危险因素。方法 回顾性分析我院和外院同期收治的 行肝切除术的228例CRLM患者的临床资料，根据肝转移时间的不同，分为同时性组(同时性CRLM，118例)和异时性组 (异时性CRLM，110例)，比较两组患者术后肝内微转移发生率，并进行影响CRLM肝内微转移的logistic回归分析。 结果 同时性组肝内微转移发生率为66.10%(78/118)，明显高于异时性组的41.82%(46/110)(P<0.05)；原发肿瘤分 化程度、原发癌灶TNM分期、原发癌灶切缘宽度是影响CRLM肝内微转移的独立危险因素(P<0.05)。结论 同时性CRLM 肝内微转移发生率高于异时性CRLM，原发肿瘤分化程度、原发癌灶TNM分期、原发癌灶切缘宽度是影响CRLM肝内微 转移的独立危险因素。

Objective To analyze the risk factors of synchronous and metachronous colorectal cancer with liver metastases (CRLM). Methods The clinical data of 228 patients with CRLM treated by hepatectomy in our hospital during the period from February to August 2017 were retrospectively analyzed. According to the different time of liver metastasis, the patients were divided into synchronous group (synchronous CRLM, 118 cases) and metachronous group (metachronous CRLM, 110 cases). The incidence of postoperative intrahepatic micrometastases was compared between the two groups, and logistic regression analysis was performed to determine the influencing factors of intrahepatic micrometastases in CRLM. Results The incidence of intrahepatic micrometastasis in the synchronous group [66.10% (78/118)] was significantly higher than that in the metachronous group [41.82% (46/110)] (χ2 =13.53, P<0.05). The differentiation degree of primary tumors, TNM stage of primary tumors, the resection margin width of primary tumors were independent risk factors for intrahepatic micrometastases in CRLM (P<0.05). Conclusion The incidence of intrahepatic micrometastases in synchronous CRLM is higher than that in metachronous CRLM. The differentiation degree of primary tumors, TNM stage of primary tumors, the resection margin width of primary tumors are independent risk factors of intrahepatic micrometastases in CRLM.