多原发大肠癌临床病理特点及诊治分析  

Clinicopathological characteristics,diagnosis and treatment of multiple primary colorectal cancer

作　　者：王艺[1] 王宇奇 赵翠翠 WANG Yi;WANG Yu-qi;ZHAO Cui-cui(Xinhua Hospital Affiliated to Dalian University Dalian 116021,China)

机构地区：[1]大连大学附属新华医院,116021

出　　处：《中国实用医药》2021年第6期32-34,共3页China Practical Medicine

摘　　要：目的对多原发大肠癌的临床病理特点进行分析,并分析该病的诊治情况。方法62例多原发大肠癌患者,收集所有患者的临床资料,并进行回顾性分析,比较同时性、异时性多原发大肠癌患者临床病理特征,分析多原发大肠癌病灶分布以及治疗情况。结果同时性多原发大肠癌患者47例,病灶94处。异时性多原发大肠癌患者15例,病灶30处。同时性多原发大肠癌患者病灶高中分化发生率84.04%高于异时性多原发大肠癌患者的40.00%,病灶黏液分泌发生率3.19%低于异时性多原发大肠癌患者的30.00%,差异均具有统计学意义(P<0.05)。而同时性、异时性多原发大肠癌患者的病灶长径、病灶部位、是否伴腺瘤、TNM分期、是否伴淋巴结转移、病灶错配修复(MMR)情况比较,差异均无统计学意义(P>0.05)。同时性多原发大肠癌患者病灶在回盲部3处、升结肠9处、横结肠9处、降结肠6处、乙状结肠26处、直肠41处,异时性多原发大肠癌患者病灶在横结肠3处、降结肠3处、乙状结肠15处、直肠9处。所有患者的治疗中均使用根治性手术治疗,对15例肠梗阻中的6例患者采用结肠支架桥接一期根治手术。结论双发癌是多原发大肠癌的主要特点,直肠、乙状结肠是该病病灶的主要分布区域。采用结肠镜对低分化、结直肠黏液腺癌患者进行密切观察具有重要意义。Objective To analyze the clinicopathological characteristics,diagnosis and treatment of multiple primary colorectal cancer.Methods The clinical data of 62 patients with multiple primary colorectal cancer was retrospectively analyzed.The clinicopathological characteristics of patients with simultaneous and metachronous multiple primary colorectal cancer was compared,and the distribution and treatment of multiple primary colorectal cancer lesions was analyzed.Results There were 47 patients with simultaneous multiple primary colorectal,with 94 lesions,and 15 patients with metachronous multiple primary colorectal,with 30 lesions.The incidence of high-medium differentiation in patients with simultaneous multiple primary colorectal was 84.04%,which was higher than 40.00%in patients with metachronous multiple primary colorectal,and the incidence of mucus secretion in lesions was 3.19%,which was lower than 30.00%in patients with metachronous multiple primary colorectal cancer.The difference was statistically significant(P<0.05).However,there was no statistically significant difference in length of the lesion,the location of the lesion,whether the patient was accompanied by adenoma,TNM stage,whether accompanied by lymph node metastasis,and the mismatch repair(MMR)of the lesion between patients with simultaneous and metachronous multiple primary colorectal cancer(P>0.05).There were 3 lesions in ileocecal region,9 lesions in ascending colon,9 lesions in transverse colon,6 lesions in descending colon,26 lesions in sigmoid colon and 41 lesions in rectum in patients with synchronous multiple primary colorectal cancer,and 3 lesions in transverse colon,3 lesions in descending colon,15 lesions in sigmoid colon and 9 lesions in rectum in patients with metachronous multiple primary colorectal cancer.All patients were treated with radical surgery,and 6 cases out of 15 patients with intestinal obstruction were treated with colonic stent bridging one-stage radical surgery.Conclusion Double cancer is the main characteristics of multipl

关 键 词：多原发大肠癌 临床病理特点 诊治分析 

分 类 号：R735.34[医药卫生—肿瘤]