直肠黏液腺癌临床病理学特征及预后分析  

Clinicopathological character and prognosis of rectum mucinous adenocarcinomas

作　　者：林延明 潘宏达[2] 彭亦凡[2] 

机构地区：[1]北京市中关村医院普外科,100190 [2]北京大学肿瘤医院胃肠中心三病区、北京大学肿瘤医院暨北京市肿瘤防治研究所、恶性肿瘤发病机制及转化研究教育部重点实验室

出　　处：《中华普通外科杂志》2016年第9期747-749,共3页Chinese Journal of General Surgery

基　　金：北京市肿瘤防治研究所院内基金（2013自主-8）

摘　　要：目的探讨直肠黏液腺癌的临床病理学特点，评估黏液腺癌对患者预后的影响。方法回顾性检索北京大学肿瘤医院结直肠癌数据库，收集并分析2010年1月至2012年1月期间于北京大学肿瘤医院外科接受根治性手术治疗的除外印戒细胞癌的直肠腺癌患者病例资料。结果353例Ⅰ～Ⅲ期直肠腺癌患者纳入到本研究，其中普通腺癌325例（92．1％），黏液腺癌28例（7．9％）。普通腺癌组和黏液腺癌组的3年无病生存率分别为83．4％和50．0％（P〈0．001）。黏液腺癌组较普通腺癌组具有更高的T分期（100％比52．3％，P〈0．001）和N分期（64．3％比32．6％，P=0．001）。发生在40岁以下的黏液腺癌显著多于腺癌（21．4％比5．5％，P=0．005）。结论直肠黏液腺癌肿瘤分期更高，发病年龄更小，预后更差。Objective To evaluate if mutinous subtype has a relevant impact on disease-free survival （DFS） of patients with rectal carcinoma. Methods The clinicopathological data of patients with rectal adenocarcinomas （ ring cell carcinoma were excluded ） undergoing radical surgery at Beijing Cancer Hospital from Jan 2010 to Jan 2012 were retrospectively studied, survival analysis was done to detect potential prognostic predictors. Results 353 patients with stage I - m rectal cancer were included in this study, of whom 28 （7.9%） had mucinous histology. The 3-year DFS for patients with a mueinous adenocarcinoma was 50. 0% and 83.4% for patients with nonmucinous adenocareinoma （ P 〈 0. 001 ） . Mucinous adenocarcinoma was associated with advanced pathologic T （T3/4, 100% vs 52. 3% , P 〈 0. 001 ） and N stage （ N1/2, 64. 3% vs. 32. 6% , P = 0. 001 ）. More patients were diagnosed under 40 years in maeinous adenocarcinoma group （21.4% vs. 5.5 % , P = 0. 005 ）. Conclusions Patients with mucinous adenocarcinoma more often present at a younger age, mucinous adenocarcinomas are associated with more advanced tumor stages, and should be regarded as a dismal prognostic factor for the survival of patients with rectal cancer.

关 键 词：直肠肿瘤 预后 黏液腺癌 

分 类 号：R735.37[医药卫生—肿瘤]