结肠癌和直肠癌发病模式和临床特点的异同分析  

The difference of morbidity and clinical characteristics betweens colon cancer and rectal cancer

作　　者：李景南[1] 赵莉[1] 苗政[1] 郑威扬[1] 杨红[1] 钱家鸣[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院消化内科,北京100730

出　　处：《中国实用内科杂志》2010年第10期916-918,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的探讨近10年来结肠癌和直肠癌发病模式及临床特点的异同,为临床早期诊断和制定筛查方案提供一定的理论依据。方法回顾性分析北京协和医院1999年1月至2008年12月1906例结肠癌和直肠癌住院患者,就其收治比、性别、年龄以及临床表现、实验室检查、诊断方法和病理分期进行分析比较。结果年龄组成方面40～60岁的直肠癌患者和70岁以上的结肠癌患者明显增多(P<0.05);临床表现方面直肠癌的便血和大便习惯改变多于结肠癌,腹部包块更多见于结肠癌;结肠癌大便常规检查异常明显低于直肠癌(P<0.01),而血红蛋白下降更为多见(P<0.01);直肠癌行癌胚抗原(CEA)检查的人数明显低于结肠癌,其出现异常的比例也偏低;直肠指诊在直肠癌患者中的阳性率较高,结肠癌确诊主要依靠结肠镜检查;治疗方式均以手术为主,Duke D期的直肠癌患者稍多。结论直肠癌和结肠癌的患病率均呈上升趋势,结肠癌临床症状缺乏特异性,对于出现相应症状的高危人群,应注重体格检查和内镜检查相结合,以期早诊早治。Objective To explore the difference of morbidity and clinical features betweens colon and rectal cancer,in order to help early diagnosis and design screening methods in China. Methods 1906 cases of colon and rectal cancer in Peking Union Medical College Hospital during 1999-2008 were retrospectively studied. Morbidity, demography characteristics, clinical manifestations, laboratory examination, methods of diagnosis and treatment ,pathological stage were analyzed respectively, Results More patients were rectal cancer aging between 40 - 60 and colon cancer aging over 70 years old （ P 〈 0.05 ）. Hematochezia and changing of bowel habit were occurred in rectal cancer, furthermore, abdominal mass was often found in colon cancer. Compared with rectal cancer, abnormal of stool routine was less and Hb decreased was more often significant in colon cancer （ P 〈 0. 01 ）. Less patients performed CEA test and abnormal was not common in rectal cancer. High positive rate of rectal touch was in rectal cancer, and colonoseopy was the mainly diagnosis method in colon cancer. Operation was the mainly treatment in both patients, More Duke D in rectal cancer than colon cancer. Conclusion Morbidity of colon canc- er and rectal cancer were increased. The clinical manifestation was less specific in colon cancer. In clinic, if the symptom occurred in high risk patients, physical examination and endoscopy should be combined in order to early diagnosis.

关 键 词：结肠癌 直肠癌 发病模式 

分 类 号：R5[医药卫生—内科学]