结直肠粘液腺癌的临床病理特征及预后分析  

作　　者：许慕明[1] 翁桢泓[1] 林韵[2] 王伟峰[1] 林佳锐[1] 庄业忠[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院腹外科,广东515041 [2]汕头大学医学院附属肿瘤医院放1科,广东515041

出　　处：《当代医学》2013年第21期21-23,共3页Contemporary Medicine

摘　　要：目的探讨结直肠粘液腺癌的临床病理特征及对预后的影响。方法选取2002年4月-2007年11月行外科切除的775例结直肠癌患者的临床病理资料。将患者分为两组:非粘液腺癌组(n=690)和粘液腺癌组(n=85);比较两组患者的临床病理特征,分析两组患者及不同组织分化程度患者的术后生存率,探索影响预后的因素。结果全组病例粘液腺癌占结直肠癌的11.0%。两组患者在性别、远处转移、术前肠梗阻和手术方式方面比较,差异无统计学意义(P>0.05)。粘液腺癌好发于右半结肠及青壮年,浸润型比例高,瘤体大,浸润深,容易发生淋巴结转移及TNM分期晚;术后总生存率比非粘液腺癌、高-中分化腺癌差;与低分化腺癌相比无明显差别。COX回归分析显示TNM分期、手术方式及组织分化程度为影响预后的独立因素。其中TNM分期是最危险的影响因素。结论结直肠粘液腺癌具有不良临床病理特征,其预后比非粘液腺癌、高-中分化腺癌差,与低分化腺癌相近,是预后的独立影响因素。Objective To investigate the clinicopathological characteristics and prognosis of colorectal mucinous adenocarcinoma（MAC）. Methods The clinicopathological data of 775 patients who underwent surgical resections from Apr. 2002 to Nov. 2007 in the department were collected. They were divided into two groups： MAC group （n=690）and non- MAC group （n=85）. The clinicopathological characteristics were compared. Survival rates of the two groups and different degrees of histological differentiation were analyzed. Prognostic factors were researched. Results A rate of patients with MAC was 11.0%. It showed that characteristics such as gender, distant metastasis, preoperative intestinal obstruction and surgical modality had no significant difference between the two groups. MAC significantly showed higher frequencies of right-sided colon involvement, younger age, more infiltrative type, large tumor size, lymphatic metastasis, advanced tumor invasion and advanced TNM stage than non- MAC. MAC had a poorer prognosis than those of non-MAC and well-moderately differentiated adenocarcinoma, but not that of low differentiated adenocarcinoma. COX regression analysis indicated TNM stage, surgical modality and histological differentiation were independent prognostic factors. The most hazardous factor was TNM stage.Conclusion Colorectal MAC has adverse clinicopathological characteristics, and a poor prognosis which is similar to low differentiated adenocarcinoma.It is also an independent prognostic factor.

关 键 词：结直肠癌 粘液腺癌 临床病理特征 预后 

分 类 号：R735.3[医药卫生—肿瘤]