351例Ⅰ~Ⅲ期左、右半结肠癌临床病理特征及生存对比研究  

Comparative study on clinicopathological characteristics and survival of 351 cases of stageⅠ-Ⅲleft and right hemicolon cancer

作　　者：阿古达木 王朝阳[1] 杨志文 郝钦[1] 张震 乌新林[1] A Gudamu;WANG Zhaoyang;YANG Zhiwen;HAO Qin;ZHANG Zhen;WU Xinlin(Department of Gastroenterological Surgery,Affiliated Hospital of Inner Mongolia Medical University,Huhhot,Inner Mongolia 010050,China)

机构地区：[1]内蒙古医科大学附属医院胃肠外科,呼和浩特010050

出　　处：《重庆医学》2021年第9期1546-1550,共5页Chongqing medicine

基　　金：内蒙古自治区自然科学基金项目[2017MS(LH)0826]。

摘　　要：目的探讨Ⅰ~Ⅲ期左半结肠癌(LCC)、右半结肠癌(RCC)的临床病理特征及生存差异。方法回顾性分析351例结肠癌手术患者临床资料。其中,RCC 181例,LCC 170例,对两组患者的临床病理特征及生存状况进行比较。结果男性结肠癌发病率高于女性(62.68%vs.37.32%,P<0.05),男性患者中LCC比例较高,女性患者中RCC比例较高。LCC、RCC发病年龄差异无统计学意义(P>0.05)。RCC患者以腹痛、腹胀、腹泻及腹部肿块等首发症状发现;而LCC患者则以便血、排便习惯改变为主要临床首发症状。与LCC患者比较,RCC患者术前更易出现贫血,癌胚抗原(CEA)、糖类抗原(CA19-9)水平更易升高;RCC肿瘤体积大,多以中低分化为主,且黏液腺癌、印戒细胞癌占比高,差异均有统计学意义(P<0.05)。LCC的5年总生存率明显高于RCC(71.88%vs.60.13%,P=0.012)。结论LCC、RCC的临床病理特征存在明显差异,且LCC患者5年总生存率高于RCC。Objective To investigate the differences in the clinicopathological characteristics and survival between stagesⅠ-Ⅲleft and right hemicolon cancer.Methods The clinical data of 351 patients with colon cancer surgery were analyzed retrospectively.Among them,181 cases were right hemicolon cancer(RCC)and 170 cases were left hemicolon cancer(LCC).The clinicopathological characteristics and survival status were compared between the two groups.Results The incidence rate of colon cancer in male was higher than that in female(62.68%vs.37.32%P<0.05),the proportion of LCC in male patients was higher,and the proportion of RCC in female patients was higher.There was no statistically significant difference in the onset age between LCC and RCC.The patients with RCC were found by the first onset symptoms of abdominal pain,abdominal distension,diarrhea and abdominal mass,while which in the LCC were hematochezia and defecation habits change.Compared with the LCC patients,RCC patients were more prone to anemia before operation,increase of carcinoembryonic antigen(CEA)and carbohydrate antigen(CA19-9)levels;the RCC tumor volume was large,and dominated by the middle and low differentiation,moreover the proportion of mucinous adenocarcinoma and signet ring cell carcinoma was high,and the difference was statistically significant(P<0.05).The 5-year overall survival rate of LCC was significantly higher than that of RCC(71.88%vs.60.13%,P=0.012).Conclusion The clinicopathological features of LCC and RCC have significant difference,moreover the overall 5-year survival rate of the LCC patients is higher than that of the RCC patients.

关 键 词：左半结肠癌 右半结肠癌 临床病理特征 生存 对比研究 

分 类 号：R735.3[医药卫生—肿瘤]