大肠多原发癌临床分析42例  

Multiple primary colorectal carcinomas:an analysis of 42 cases

作　　者：顾国利[1] 王石林[1] 魏学明[1] 周晓武[1] 黄蓉蓉[1] 

机构地区：[1]空军总医院普通外科,北京市100036

出　　处：《世界华人消化杂志》2006年第19期1933-1936,共4页World Chinese Journal of Digestology

摘　　要：目的：探讨大肠多原发癌及其肠外器官恶性肿瘤的流行病学、临床病理特点及诊治方法．方法：对我院1980-2005年收治的42例大肠多原发癌及其肠外恶性肿瘤的临床、病理及随访资料进行回顾性分析．结果：本组病例占我院同期收治的所有大肠癌的3．10%(42/1354),其中同时性大肠多原发癌13例(0．96%)；异时性大肠多原发癌29例(2．14%)；合并肠外器官恶性肿瘤的有20例(1．48%)．大肠癌灶以右半结肠和直肠为多,肠外癌灶以胃、小肠、乳腺、卵巢、子宫为多；病理均以腺癌为主．共有12例(28．6%)符合遗传性非息肉病性大肠癌(HNPCC)阿姆斯特丹标准Ⅱ,16例(37．2%)符合中国人HNPCC诊断标准．结肠纤维镜检查有助于多原发癌的检出．结论：大肠多原发癌的发病率较高,其流行病学和临床病理特点突出．应注意重视结肠纤维镜检查,术中应仔细全面探查,加强术后随访有助于HNPCC的发现和诊断,以避免误诊漏诊．AIM： To conclude the clinical characteristics of multiple primary colorectal carcinoma （MPCC）. METHODS： The clinical data of 42 patients with MPCC out of 1354 primary colorectal cancer cases, who were treated in our hospital from 1980 to 2005, were retrospectively analyzed. RESULTS： The percentage of patients with MPCC was 3.10% （synchronous： 0.96%; metachronous： 2.14%）. Of the 42 cases, 20 （1.48%） were accompanied by carcinoma of other organs. Adenocarcinoma was the most common cancer, locating at the right colon （46.3%） and rectum （31.3%）. The tumors of other organs were mainly located at stomach, small intestine, breast, ovary and uterus. The data of 12 cases （12/42, 28.6%） were in accordance with Amsterdam criteria Ⅱ for hereditary nonpolyposis colorectal cancer （HNPCC）, and the data of 16 cases （16/42, 37.2%） were in accordance with the Chinese criteria for HNPCC. Colon fiberscopy was helpful in the diagnosis of MPC. CONCLUSION： MPCC, with a high incidence rate, has particular epidemic, clinical and pathological characteristics. Colon fiberscopy is important in the diagnosis of MPC, and postoperative following up should be strengthened for the diagnosis of HNPCC.

关 键 词：结肠直肠肿瘤 大肠多原发癌 临床特点 遗传性非息肉病性大肠癌 

分 类 号：R735.34[医药卫生—肿瘤] R736.1[医药卫生—临床医学]