大肠粘液腺癌的临床病理特点及预后分析  

Clinicopathological characritics and prognosis of large intestinal mucoid adenocarcinoma

作　　者：郑淼[1] 李继坤[1] 周立生[1] 

机构地区：[1]上海交通大学附属第一人民医院普外科,上海200080

出　　处：《中国癌症杂志》2005年第4期383-384,386,共3页China Oncology

摘　　要：目的:探讨大肠粘液腺癌(MUC)与大肠非粘液腺癌(non-MUC)的临床病理差异及其综合治疗方面应该注意的问题.方法:1994～2003年收治的1 715例大肠癌中粘液腺癌为197例.比较MUC与non-MUC的临床病理资料及预后.结果:MUC中年轻人(年龄<45岁)比例明显升高MUC:(21.3%vs非MUC:12.6%) ,部位多见于直肠、升结肠;MUC组更易向肠周组织浸润及播散(侵润至浆膜外:MUC:59.9%vs非MUC: 35.1%),亦易发生周围的淋巴结转移(MUC:41.6%对非MUC 21.6%);MUC晚期患者比例增高(D期:MUC:44.1%对非MUC: 22.1%);根治性手术切除率低(MUC组:34%vs非MUC组:69%),术后复发率高、预后较差.结论:大肠粘液腺癌的预后差,与其临床病理特点相关,对大肠粘液腺癌应采取较积极的综合治疗方式.Purpose：To investigate the elinicopathological characristies of colorectal mucinous adenocarcinoma（MUC）,which is generally believed to have a poor prognosis,in an attempt to assess ways which the surgical outcome can be improved.Methods：From 1994 to 2003,1715 large intestinal cancer patients underwent operation,among them,1997 patients were with MUC.The clinicopathologial parameters and prognosis of MUC and non-MUC were analyzed retrospectively.Results：There were no significant differences in sex, lumor site and size,Patients with MUC had higher rate of serosal invasion（MUC：59.9% va non-MUC：35.1%）,invasive type lymph-node involvemnet（MUC：41.6% vs non-MUC 21.6%）,Patients with MUC were of more advanced stage（D state：MUC：44.1% vs non-MUC：22.1%）.Conclusions：Based on these findings,a more aggressive attitude toward surgical intervention is recommended,includig extensive lymph node dissection and the resection of adjacent organs that seems to be affected microscopically,to improve the surgical outcome of this clinical entity.

关 键 词：大肠癌 大肠粘液腺癌 临床病理学 

分 类 号：R735.3[医药卫生—肿瘤]