39例多原发结直肠癌的临床研究  

Clinical analysis of 39 cases of multiple primary colorectal carcinoma

作　　者：付金金[1] 黄载伟 林英豪[1] 肖冰[1] 

机构地区：[1]南方医科大学南方医院消化科,广东广州510515

出　　处：《南方医科大学学报》2013年第4期578-581,共4页Journal of Southern Medical University

基　　金：广东省卫生厅医疗事业专项课题(2011315)

摘　　要：目的分析结直肠多原发癌其临床特征及预后。方法对本院2000年1月～2007年12月收治的1462例结直肠癌病例进行回顾性分析,根据Warran和Gates提出的多原发癌(MPC)的诊断标准,筛选出39例MPC,并对其发病年龄、5年生存率、病变部位以及治疗方式与生存时间的关系等进行统计。结果(1)MPC的发生率为2.67%(39/1462),同时性多原发癌(SC)18例,异时性多原发癌(MC)21例;(2)MPCC好发于左半结肠和直肠,发病年龄为61.02±13.94岁,5年生存率为61.76%;MC的预后优于SC;(3)3例早期MPCC,根治性手术后5年生存率100%;30例中晚期MPCC行根治性手术+辅助性化疗,1-、3-、5-年生存率分别为93.33%、83.33%、73.33%,3例中晚期MPCC行姑息性手术+辅助性化疗,1年和3年生存率分别为66.67%和0,3例中晚期MPCC仅行姑息性化疗,1年和3年生存率也分别为66.67%和0。结论早期诊断并有效治疗MPC,可提高患者的生存率;根治性手术和化疗对中晚期MPCC患者的生存与预后明显有益。Objective To investigate the clinical features and prognosis of multiple primary colorectal carcinoma（MPCC）. Methods Among the 1462 patients with colorectal cancer admitted in our department from January 2000 to December 2007,39 patients with MPCC were identified based on the Warran and Gates MPC diagnosis criteria.The age of onset,5-year survival rate,lesion location and therapies were analyzed retrospectively.Results The incidence of MPCC was 2.67%（39/1462）. Eighteen of the patients had synchronous carcinomas and 21 were diagnosed to have metachronous carcinomas.Most of the tumors were located in the left colon and rectum.The average age of onset was（61.02±13.94） in these patients who had an overall 5-year survival rate of 61.76%.The patients with metachronous carcinomas had a better prognosis than those with synchronous carcinomas.The 5-year survival rate of 3 early-stage cases（TNM stage I） was 100% after radical surgery.Thirty advanced cases underwent radical surgery combined with adjuvant chemotherapy,and their 1-,3-and 5-year survival rates were 93.33%,83.33%,and 73.33%,respectively.The 1-and 3-year survival rates of 3 advanced cases undergoing palliative surgery and adjuvant chemotherapy were 66.67% and 0,respectively.The 1-and 3-year survival rates of another 3 advanced cases with palliative chemotherapy were 66.67% and 0,respectively.Conclusion Early diagnosis and effective treatment can help prolong the survival of MPC patients.Surgical intervention and chemotherapy can improve the survival and prognosis of patients with advanced MPCC.

关 键 词：多原发结直肠癌 发病部位 TNM分期 病理类型 预后 

分 类 号：R735.3[医药卫生—肿瘤]