Background:The “streamline flow” of the portal vein (PV) is a controversial yet well-known theory presented almost 125 years ago. It states that blood from the superior mesenteric vein (SMV) goes preferentially to the right liver lobe, while splenic and inferior mesenteric veins divert blood predominantly to the left lobe, affecting this way the metastatic distribution of colorectal cancer (CRC). The aim of this systematic review is to assess its validity by examining and combining all the relevant literature with a critical eye.Materials and methods:This study constitutes a systematic review of the literature and adheres to all PRISMA system criteria. Three search engines (PubMed, Google Scholar, and the Cochrane Library) were used, and 11 out of 435 studies between 1984 and 2024 were finally included in this meta-analysis. All statistical analysis was conducted using RevMan Web, Version: 7.12.0, and Jamovi v 2.3.260 software.Results:The meta-analysis revealed that regardless of the primary location of the tumor, the metastases preferentially migrate to the right lobe due to various possible reasons. The prevalence of metastases from right colon cancer to the right liver lobe was 75%, while the prevalence of left colon cancer metastases to the right lobe was 68%. This difference was not found statistically significant.Conclusions:The theory has been proven inaccurate, at least from the perspective of the origin-associated distribution of CRC metastases in the liver lobes, and therefore bears no clear predictive value. Further research under different perspectives is essential for determining more definite conclusions.
背景：门静脉（PV）的“流线型血流”理论是一个存在争议但广为人知的理论，提出至今已有近125年。该理论认为，来自肠系膜上静脉（SMV）的血液优先流向肝脏右叶，而脾静脉和肠系膜下静脉的血液则主要流向左叶，从而影响结直肠癌（CRC）的转移分布。本系统综述旨在通过审慎审视并整合所有相关文献，评估该理论的有效性。 材料与方法：本研究为文献系统综述，严格遵循PRISMA系统标准。检索了三个数据库（PubMed、Google Scholar和Cochrane Library），最终从1984年至2024年间的435项研究中纳入11项进行荟萃分析。所有统计分析均使用RevMan Web（版本7.12.0）和Jamovi（版本2.3.260）软件完成。 结果：荟萃分析显示，无论肿瘤原发部位如何，转移灶均优先迁移至右肝叶，其原因可能多样。右半结肠癌肝转移至右叶的发生率为75%，而左半结肠癌肝转移至右叶的发生率为68%，该差异无统计学意义。 结论：该理论已被证明不准确，至少从结直肠癌肝转移灶与原发部位相关的分布角度来看如此，因此不具备明确的预测价值。需从不同角度开展进一步研究以得出更明确的结论。
肿瘤(癌症)患者之家