结直肠癌的临床病理特征及其与血清25羟基维生素D相关性的分析  

Clinicopathological Characteristics of Colorectal Cancer and Correlation with Serum 25-Hydroxyvitamin D

作　　者：徐艳丽[1,2] 郑晴晴[2] 常英[2] 

机构地区：[1]苏州大学医学部,215123 [2]上海交通大学附属第六人民医院消化内镜室

出　　处：《胃肠病学》2014年第3期156-160,共5页Chinese Journal of Gastroenterology

摘　　要：背景:近年结直肠癌(CRC)的发病率和死亡率呈上升趋势,熟悉临床病理特征有助于提高CRC诊断水平。目的:总结CRC的临床病理特征并分析其与血清25羟基维生素D[25(OH)D]的相关性。方法:回顾性分析249例经结肠镜活检或术后病理证实的CRC患者的临床资料,以ELISA法检测血清25(OH)D水平,并分析其与CRC临床病理特征的相关性。结果:CRC好发于>60岁的老年人(69.5%),男女之比为1.33∶1;直肠为最常见的发病部位(40.4%),便血为最常见的症状(41.0%),肿瘤大体类型以溃疡浸润型(54.9%)为主,病理类型主要为管状腺癌(75.1%)。与非老年组相比,老年组直肠癌发生率明显降低,右半结肠癌发生率明显上升,浸润型CRC少见,Ⅱ期CRC明显升高,排便习惯和性状改变更常见,细胞中分化率明显升高,差异均有统计学意义(P<0.05)。老年、右半结肠和分期较晚的CRC患者血清25(OH)D水平明显降低(P<0.05)。结论:老年CRC的发病部位、肿瘤类型、临床分期、临床表现和分化程度与非老年患者均有明显差异。血清25(OH)D水平可能与CRC患者年龄、发病部位。Background：The incidence and mortality of colorectal cancer （CRC） are increasing in recent years,familiar with clinicopathological characteristics of CRC is helpful for improving the diagnosis level of CRC.Aims：To analyze clinicopathological characteristics of CRC and its correlation with serum 25-hydroxyvitamin D [25 （OH） D].Methods：Clinical data of 249 patients with CRC diagnosed by biopsy or postoperative pathological examination were retrospectively analyzed.Serum 25 （OH）D was determined by ELISA,and its correlation with clinicopathological characteristics was analyzed.Results：CRC commonly occurred in patients with age 〉 60 years （69.5%）,ratio of male to female was 1.33∶ 1.Rectum was the most frequent site for CRC （40.4%）,and hematochezia was the most common symptom （41.0%）.Ulcer infiltration type （54.9%） was the predominant gross findings of CRC,and the most frequent histological subtype was tubular adenocarcinoma （75.1%）.Compared with non-elderly group,incidences of rectal cancer,infiltrating type CRC were significantly decreased in elderly group （P 〈 0.05）,and incidences of right hemicolon cancer,TNM stage Ⅱ,changes in defecation habit and character,moderately differentiated tumor were significantly increased （P 〈 0.05）.Serum 25 （OH） D level was decreased more obviously in patients with elder age,right hemicolon cancer and advanced TNM stage （P 〈 0.05）.Conclusions：CRC location,gross finding,clinical stage,clinical manifestation and tumor differentiation are significanly different between elderly group and non-elderly group.Serum 25 （OH） D level in CRC patients may be correlated with age,tumor location and TNM stage.

关 键 词：结直肠肿瘤 结肠镜检查 25羟基维生素D 回顾性研究 

分 类 号：R735.3[医药卫生—肿瘤]