异时性多原发结直肠癌临床特点分析31例  

Clinicopathologic characteristics of metachronous colorectal cancer:an analysis of 31 cases

作　　者：郑阳春[1] 燕锦[1] 刘宝善[1] 刘超[1] 徐琳[1] 

机构地区：[1]四川省肿瘤医院腹部外科,四川省成都市610041

出　　处：《世界华人消化杂志》2009年第6期627-631,共5页World Chinese Journal of Digestology

基　　金：四川省卫生厅基金资助项目;No.070020~~

摘　　要：目的:探讨异时性多原发结直肠癌的临床特点,为临床诊治提供参考.方法:回顾性总结31例异时性多原发结直肠癌的临床资料,分析肿瘤发生、分布及治疗与预后.结果:31例患者,平均5.1年出现次发癌,平均3.8年后3例出现第3癌,平均3.5年后2例再发第4癌.45.2%的患者合并存在腺瘤.59.5%的首发癌位于直肠、乙状结肠;大部分次发癌的分化程度、病理分期好于首发癌或与之相同;首发癌术后平均存活8.3年,5年生存率84.8%.结论:大多数异时性多原发结直肠癌的首发癌位于直肠及乙状结肠.合并存在腺瘤是发生该病的危险因素,根治术后应进行定期复查.AIM： To investigate the clinicopathologic characteristics of metachronous colorectal cancer and to facilitate its diagnosis and treatment.METHODS： Thirty-one cases diagnosed with metachronous colorectal cancer were treated and closely followed up. Clinical records such as the occurrence, distribution, and stage of index and secondary tumors were retrospectively reviewed. The prognosis after surgery was also analyzed.RESULTS： Secondary tumors occurred in all 31 patients in an average of 5.1 years after the diagnosis of their index colorectal cancers. Three cases had a third tumor after an average of 3.8 years, and then two of them had a fourth tumor after an average interval of 3.5 years. Of the 31 cases, 45.2 percent of them had synchronous adenoma. The majority of index tumors （59.5%） were located in the rectum or sigmoid colon. Most of the secondary tumors were similar to or better than their index tumors in the levels of differentiation and pathological grades. An average survival of 8.3 years was achieved after the radical operation of the index tumor. The 5-year survival rate reached 84.8%.CONCLUSION： In patients with metachronous colorectal cancer, the primary tumor is more commonly located in the rectum or sigmoid co- lon. With the occurrence of subsequent tumor, interval time was shortened gradually. An intensive periodic checkup after operation is strongly recommended for improvement of prognosis.

关 键 词：结直肠癌 多原发癌 异时性 临床特点 

分 类 号：R735.3[医药卫生—肿瘤]