19例异时原发结直肠癌的临床特点分析  

Analysis of clinical features of metachronous primary colorectal carcinomas in 19 cases

作　　者：林航[1] 邓武坚[1] 谢富华[1] 陈德[1] 

机构地区：[1]广州医科大学第二附属医院胃肠外科,广州515000

出　　处：《岭南现代临床外科》2014年第1期44-46,共3页Lingnan Modern Clinics in Surgery

基　　金：广州市科技和信息化局项目(20130000170)

摘　　要：目的探讨异时原发结直肠癌的临床特点。方法回顾性分析2000年～2012年间19例异时原发结直肠癌的临床特点及治疗效果。结果我科在2000年～2012年施行1304例结直肠癌根治术的患者中，发现19例异时原发结直肠癌，概率约为1．4％。第二癌出现在首发癌治疗后15到135个月，中位77个月，平均时间为术后74．2±29．5个月。约68．4％的患者（13／19）第2癌发生时间超过5年。与首发癌比较，第2癌体积更小，多发于升结肠。78．6％的患者存在错配修饰基因蛋白表达缺失。5年存活率达100％，全部患者在观察期内均未发现局部复发和血道转移。结论异时原发结直肠癌的发病率较低，错配修饰基因突变率较高．其预后较好。Objective To investigate the clinical features of metachronous primary colorectal carcinomas. Methods From 2000 to 2012,19 cases of the clinical features and outcomes of metachronous colorectal carcinoma were retrospectively analyzed. Results In the 1304 cases of radical operation of colorectal carcinoma, the metachronous primary colorectal carcinoma were found in 19 cases during 2000 to 2012. The incidence rate of metachronous primary colorectal carcinoma was 1.4%. The metachronous cancer was confirmed in 15 to 135 months after operation of primary colorectal cancer （mean 77 months and 74.2±29.5 months on average）. 68.4% of the metachronous carcinomas were found in 5 years after first operation. Compared with the initial carcinomas, the metachronous carcinomas showed smaller mass in size and more located in the ascending colon. ＂78.6% of the patients had deficiency of mismatching modification gene protein expression. The 5-years survival rate was 94.7%. All patients were without lymphatic metastasis and blood metastasis. Conclusion Metachronous primary colon carcinomas is low in incidence rate, but it has a higher mismatching maodification gene and with better prognosis.

关 键 词：异时原发结直肠癌 临床特点 预后 错配修饰基因 

分 类 号：R656.9[医药卫生—外科学]