70岁以上老年结直肠癌患者273例临床病理及预后分析  

Clinicopathology and Prognosis of Elderly Patients with Colorectal Cancer:An Analysis of 273 Cases

作　　者：郭茜[1] 齐秀恒[1] 武振明[1] 刘欢[1] 肖芳芳[1] 

机构地区：[1]中国石油中心医院,河北廊坊065000

出　　处：《肿瘤学杂志》2017年第3期214-217,共4页Journal of Chinese Oncology

摘　　要：[目的]探讨70岁以上老年结直肠癌患者临床特点及预后。[方法]回顾性分析273例年龄≥70岁的老年结直肠癌患者的临床资料。[结果]70岁以上的新发老年结直肠癌患者占同期住院结直肠癌患者的29.4%(273/927),伴随有基础疾病者205例(75.1%),癌胚抗原(CEA)异常92例(33.7%),D-二聚体异常129例(47.3%),血小板增高89例(32.6%)。病理类型以中分化腺癌居多,116例(42.5%);病理分期以Ⅲ、Ⅳ期为主,Ⅲ期109例(39.9%),Ⅳ期130例(47.6%);远处转移中单发转移78例(60.0%),多发转移52例(40.0%);肝转移92例(70.8%),肝外转移38例(29.2%)。接受手术治疗190例(69.6%),接受化疗171例(62.6%),接受放疗85例(31.1%),仅行姑息支持治疗68例(24.9%)。患者中位生存时间30个月,1年生存率为85.7%(234/273),3年生存率为60.8%(166/273),5年生存率为30.8%(84/273)。69例(36.5%)死于肿瘤进展,98例(51.9%)死于其他基础疾病。[结论 ]老年结直肠癌患者,尤其70岁以上患者,伴随的基础疾病、合并症增多,对于这部分患者既要进行个体化抗肿瘤治疗,又要兼顾伴随疾病的管理。规范化个体化治疗能使患者生存期延长。[Objective] To analyze the clinicopathologic characteristics and prognosis of elderly patients with colorectal cancer. [Methods] Total 927 patients with colorectal cancer were admitted in our hospital during January 2008 to October 2011,among whom 273 were aged 70 or above（29.4%）. The clinical data of 273 elderly patients were analyzed retrospectively. [Results]Among 273 elderly patients,205 cases（75.1%） were complicated with chronic diseases including hypertension,cardiac disease,diabetes or others;92 cases（33.7%） presented abnormal serum carcinoembryonic antigen（CEA）,129 cases（47.3%） had abnormal D-dimeride,89 cases（32.6%） had thrombocytosis. The highly differentiated adenocarcinoma was the most common pathological type（116 cases,42.5%）. There were 109 cases with stage Ⅲ（39.9%） and 130 cases with stage Ⅳ（47.6%）;there were 78 cases（60.0%） with single metastasis,52 cases（40.0%） with multiple metastases;92 cases（70.8%） with liver metastasis and 38 cases（29.2%） with extra-hepatic metastasis.190 cases（69.6%） received surgical,171 cases（62.6%） received chemotherapy and 85 cases（31.1%）received radiotherapy. The1-,3-,5-year survival rates were 85.7%（234/273）,60.8%（166/273）and 30.8%（84/273）with median survival time of 30 months. Sixty nine cases（36.5%）died from tumor progression and 98 cases（51.9%）died from other causes. [Conclusion] Most elderly colorectal cancer patients are complicated with chronic diseases. For these patients,individualized antitumor treatment and management of accompanied diseases are necessary,which would prolong survival of the patients.

关 键 词：结直肠肿瘤 老年人 临床病理学 

分 类 号：R735.3[医药卫生—肿瘤]