大肠癌临床特征分析  

Clinical feature analysis of colorectal cancer

作　　者：张妍 崔彬彬[2] 田素礼[3] 王达[4] 李钰[5] 董新舒[2] 王震[3] 赵亚双[1] 

机构地区：[1]哈尔滨医科大学公共卫生学院流行病学教研室,黑龙江哈尔滨150086 [2]哈尔滨医科大学附属第三医院(黑龙江省肿瘤医院)腹外科,黑龙江哈尔滨150040 [3]哈尔滨医科大学附属第二医院普外科,黑龙江哈尔滨150086 [4]哈尔滨医科大学科研处,黑龙江哈尔滨150086 [5]哈尔滨工业大学生命科学学院,黑龙江哈尔滨150001

出　　处：《黑龙江医药科学》2006年第3期35-37,共3页Heilongjiang Medicine and Pharmacy

基　　金：国家自然科学基金资助项目(No.30371243);哈尔滨市回国人员基金项目(No.2005AFLXJ017)

摘　　要：目的：探讨典型的遗传性非息肉病性大肠癌（hereditary non-polyposis colorectal cancer，HNPCC）、非典型非息肉病性大肠癌和散发性大肠癌三种不同形式大肠癌的临床特征，为本病的早期诊断和治疗提供依据。方法：通过检索病历和电话访谈调查2001-01～2004-12经哈尔滨医科大学附属第三医院确诊的住院结直肠癌患者及调查员面谈的方式调查2004-07～2005-07经哈尔滨医科大学附属第二、三医院确诊的住院结直肠癌患者。结果：①共调查诊断为HNPCC的患者64例（3．57％）；非典型HNPCC28例（1．56％）；散发性大肠癌1697例（94．75％）。②平均发病年龄为（56．9±12．1）岁。不同形式大肠癌的平均发病年龄有差别（P=0．001）。HNPCC的发病年龄最小。③不同形式大肠癌的肿瘤发生部位有差别（P=0．001），总体上以直肠癌为主，HNPCC和散发大肠癌右半结肠癌较多发。④病理学特点中，病理形态、组织学分类及分化程度无显著性差异。而Dukes分期有显著性差异（P=0．044），HNPCC以C期为主，非典型和散发大肠癌以B期为主。结论：典型HNPCC发病年龄早，右半结肠高发。建议应对患者及家属进行长期监测和随访，以便早期诊断和治疗，改善大肠癌患者的预后。Objective： To investigate the clinical features of Colorectal cancer in its three different forms： typical hereditary non-polyposis colorectal cancer（HNPCC）, atypical hereditary non-polyposis colorectal cancer and sporadic colorectal cancer, in order to provide evidence for early diagnosis and treatment, Methods：By retrieving case files and call visits, colorectal cancer patients diagnosed by the third Affiliated Hospital of Harbin Medical University from 2001-01 to 2004-12 were investigated. From 2004-07 to 2005-07, colorectal cancer patientsdiagnosed in the second and third Affiliated Hospital of Harbin Medical University were interviewed by investigators and filled the questionnaire. Results： ① Among the patients investigated, 64 cases were HNPCC（3. 57%）; 28 cases were a typical hereditary non- polyposis eoloreetal cancer （1.56%） and 1697 cases were sporadic eoloreetal cancer （94.75 %）.②Average age of onset was （56. 9±12. 1） years. Average age of onset of colorectal cancer in various forms were significant different （P = 0. 001） . Patients with HNPCC were the youngest. ③The tumors had different locations （P = 0. 001） . In general most patients were rectal cancer. Then right side colon predominated in HNPCC and sporadic colorectal cancer. ④Within the features of pathobiology, there were no significant differences in patho-appearance, histology grouping and differentiation degree. But significant difference in Dukes Staging （P = 0. 044） was observed, most HNPCC was in C stage, and most atypical hereditary non-polyposis and sporadic colorectal cancer in B stage. Conclusion： The age of onset of typical HNPCC was younger, and right side colon cancer predominated. We suggest that patients and their families should be long-term monitored and followed up to be diagnosed and treated earlier, and prognosis of colorectal cancer will be improved.

关 键 词：大肠癌 HNPCC 临床特征 

分 类 号：R735.34[医药卫生—肿瘤]