不同部位结肠癌患者临床病理特征与生存状况研究  

Clinical and pathological characteristics and survival status of patients with colon cancer at different locations

作　　者：张清[1] 黄润生[1] 崔磊[1] 陈吉祥[1] 瞿建国[1] 柳益书[1] 

机构地区：[1]江苏大学附属医院普外一科,江苏镇江212001

出　　处：《中国现代医学杂志》2016年第19期85-88,共4页China Journal of Modern Medicine

摘　　要：目的探讨不同部位结肠癌患者临床病理特征与生存状况。方法回顾性分析2007年1月-2011年1月该院收治的199例结肠癌患者的病历资料,根据发病部位分为左半结肠癌组(87例)和右半结肠癌组(112例)。比较两组的基线资料、临床表现、病理学特征、治疗方法等资料,对所有患者定期进行随访,采用KaplanMeier法计算两组患者的5年生存率,并用Log-rank检验进行比较。结果左半结肠癌中年龄≥65岁的比例、腹痛、术前癌胚抗原升高及贫血发生率低于右半结肠癌;便血发生率高于右半结肠癌(P<0.05)。病理学特征方面,左半结肠癌中肿瘤直径>5 cm、黏液分泌、脉管瘤栓、淋巴结检出数目>12个的比例低于右半结肠癌,且两组的TNM分期、分化程度比较,差异有统计学意义(P<0.05)。左半结肠癌组的Ⅲ期、Ⅳ期及总体5年生存率高于右半结肠癌组(P<0.05)。结论与左半结肠癌比较,右半结肠癌患者中老年患者更常见,肿瘤恶性程度和5年生存状况更差,且预后差异主要体现在Ⅲ、Ⅳ期患者中。Objective To investigate the clinical and pathological characteristics and survival status of patients with colon cancer at different locations. Methods Medical records of 199 patients with colon cancer in our hospital from January 2007 to January 2011 were retrospectively analyzed. They were divided into leftsided colon cancer group （n = 87） and right-sided colon cancer group （n=112） according to the location. Baseline data, clinical manifestation, pathological characteristics and treatment methods were compared between the two groups. Then they all received regular follow-up. Kaplan-Meier method was performed to calculate 5- year survival rate, which was compared with the Log-rank test. Results The proportion of the patients with age ≥65, and the incidence of abdominal pain, elevated preoperative CEA and anemia in the left-sided colon cancer group were significantly lower than those in the fight-sided colon cancer group, the incidence of hematochezia was significantly higher than that in the right-sided colon cancer （P 〈 0.05）. For pathological characteristics, the proportions of tumor diameter 〉 5 cm, mucinous adenocarcinoma, vascular invasion, and detected lymph node number 〉12 in the left-sided colon cancer group were significantly lower than those in the right-sided colon cancer; and there were statistically significant differences in TNM staging and degree of differentiation between the two groups （P〈 0.05）. The 5-year survival rate of stage m and stage IV colon cancer patients and the overall survival rate in the left-sided colon cancer group were significantly higher than those in the right-sided colon cancer group （P 〈 0.05）. Conclusions Compared with left-sided colon cancer, right colon cancer is more common in elderly patients, has higher tumor malignant degree and worse 5-year survival situation,and the difference ofprognosis mainly occurs in patients in stage Ⅲ and stage Ⅳ.

关 键 词：结肠肿瘤 临床表现 病理学 生存状况 

分 类 号：R735.3[医药卫生—肿瘤]