海南省部分地区胃肠道恶性肿瘤患者临床病理特征分析  

Clinicopathological characteristics of patients with gastrointestinal malignant tumor in some parts of Hainan province

作　　者：颜兵[1] 刘辉[1] 游俊浩[1] 李方[1] Yan Bing Liu Hui You Junhao Li Fang(Department of Oneology, Hainan Branch of PLA General Hospital, Sanya 572000, Chin)

机构地区：[1]解放军总医院海南分院肿瘤科,三亚572000

出　　处：《肿瘤研究与临床》2017年第8期556-560,共5页Cancer Research and Clinic

基　　金：国家自然科学基金（81503391）;海南省自然科学基金（817352）;三亚市医疗卫生科技创新项目（2016YW08）

摘　　要：目的 分析海南省部分地区胃肠道恶性肿瘤患者与省外患者临床病理特征的异同.方法 收集解放军总医院海南分院2012年6月至2016年6月经病理确诊的胃肠道恶性肿瘤患者315例（肠癌223例、胃癌92例）,将性别、年龄、肿瘤位置、肿瘤细胞分化程度、体质量指数（BMI）、体表面积（BSA）、肿瘤标志物水平、TNM分期、微卫星状态、人类表皮生长因子受体2（Her-2）表达情况、Ki-67指数、危险因素等临床病理参数,按海南省内、省外分组进行统计分析.结果 相比省外患者,海南省部分地区胃肠道恶性肿瘤患者确诊时BMI[肠癌：（23±3）kg/m^2比（24±4）kg/m^2,t=-3.69,P〈0.05;胃癌：（21.50±3.15）kg/m^2比（23.00±3.61）kg/m^2,t=-2.11,P=0.04]和BSA[肠癌：（1.73±0.18）m^2比（1.82±0.18）m^2,t=-3.46,P〈0.05;胃癌：（1.73±0.16）m^2比（1.81±0.18）m^2,t=-2.09,P=0.04]较低.确诊时省内肠癌患者的年龄相对更小[（57±13）岁比（62±13）岁,t=-2.30,P=0.02],术前癌胚抗原（CEA）水平阳性率更高（χ^2=4.56,P=0.03）,此外T分期（χ^2=8.31,P=0.04）和TNM分期（χ^2=11.19,P=0.01）更高,而胃癌则差异无统计学意义（均P〉0.05）.结论 海南省部分地区胃肠道恶性肿瘤患者,特别是肠癌患者相比省外患者具有独特的临床病理特征,主要表现在确诊时年龄小,BMI和BSA偏低,术前CEA水平在此类患者诊断中可能具有较大价值.Objective To analyze the clinicopathological characteristics of patients with gastrointestinal malignant tumor in some parts of Hainan province and alien patients outside of Hainan province. Methods Three hundred and fifteen patients who were diagnosed by pathological confirmation were selected in Hainan Branch of PLA General Hospital from Jun 2012 to June 2016, clinicopathological parameters including age, gender, tumor location, cancer cell differentiation, body mass index （BMI）, body surface area （BSA）, value of preoperative tumor markers, TNM stages, microsatellite state, human epidermal growth factor receptor 2 （Her-2） staining, Ki-67 index and risk factors were collected and compared between local and alien patients. Results In contrast with patients outside of Hainan province, a significant lesser BMI [colorectal cancer： （23 ± 3） kg/m^2 vs. （24 ± 4） kg/m^2, t=-3.69, P〈0.05; gastric cancer： （21.50 ± 3.15） kg/m^2 vs. （23.00 ± 3.61） kg/m^2, t=-2.11, P=0.04] and BSA [colorectal cancer：[（1.73 ± 0.18） m^2 vs. （1.82 ± 0.18） m^2, t=-3.46, P〈0.05;gastric cancer：（1.73 ± 0.16） m^2 vs. （1.81 ± 0.18） m^2, t=-2.09, P=0.04] were found in local patients. Local patients with colorectal cancer were much more younger [（57 ± 13） years old vs. （62 ± 13） years old, t=-2.30, P=0.02], with corresponding elevated positive rate of preoperative CEA （χ^2=4.56, P= 0.03）, T stages （χ^2 = 8.31, P= 0.04） and TNM stages （χ^2= 11.19, P= 0.01）, however, no such difference was detected in gastric cancer patients （all P〉0.05）. Conclusions Patients with gastrointestinal cancer in some parts of Hainan province, in particular, colorectal cancer patients, present some exceptional clinicopathological features, which are marked by younger age at diagnosis, low level of BMI and BSA. In addition, preoperative level of CEA would be of important for these patients.

关 键 词：肠肿瘤 胃肿瘤 肿瘤标记 生物学 肿瘤分期 

分 类 号：R735[医药卫生—肿瘤]