左、右半结肠癌患者临床病理特征分析
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摘要
目的比较左、右半结肠癌患者的临床病理特征差异。方法以2015年1月至2016年12月在广西医科大学第一附属医院结直肠肛门外科住院手术的489例结肠癌患者为研究对象,比较左、右半结肠癌临床病理特征差异。结果两组患者肿瘤最长径、大体形态、病理组织学类型、淋巴结检出数、T分期、M分期、TNM分期比较,差异均有统计学意义(均P <0.05),性别、年龄、肿瘤分化程度、N分期比较,差异均无统计学意义(均P> 0.05)。结论与左半结肠癌相比,右半结肠癌中粘液细胞癌、印戒细胞癌更多见,浸润深度更深,恶性程度更高,TNM分期更晚。
Objectives To compare the clinicopathological features between left-sided and right-sided colon cancer. Methods489 patients with colon cancer hospitalized for surgery at the Department of Colorectal & Anal Surgery, The First Affiliated Hospital of Guangxi Medical University, were recruited. the Clinicopathological features were compared between left-sided and rightsided colon cancer. Results There were significant differences between the two types of colon cancer in diameter of tumor,gross morphology, histological type, the number of lymph nodes detdcted, T staging, M staging, and TNM staging(P < 0.05).There was no significant difference in sex, age, differentiation of tumor, and N staging between the two types of colon cancer(P >0.05). Conclusion Compared with left-sided colon cancer, mucous adenocarcinoma and signet ring cell carcinoma were more common in right-sided colon cancer. Right-sided colon cancer also had deeper invasion depth, higher malignancy and more advanced TNM staging.
Objectives To compare the clinicopathological features between left-sided and right-sided colon cancer. Methods489 patients with colon cancer hospitalized for surgery at the Department of Colorectal & Anal Surgery, The First Affiliated Hospital of Guangxi Medical University, were recruited. the Clinicopathological features were compared between left-sided and rightsided colon cancer. Results There were significant differences between the two types of colon cancer in diameter of tumor,gross morphology, histological type, the number of lymph nodes detdcted, T staging, M staging, and TNM staging(P < 0.05).There was no significant difference in sex, age, differentiation of tumor, and N staging between the two types of colon cancer(P >0.05). Conclusion Compared with left-sided colon cancer, mucous adenocarcinoma and signet ring cell carcinoma were more common in right-sided colon cancer. Right-sided colon cancer also had deeper invasion depth, higher malignancy and more advanced TNM staging.
引文
[1]SIEGEL R L,MILLER K D,JEMAL A.Cancer statistics,2018[J].Ca A Cancer Journal for Clinicians,2018,60(5):277-300.
[2]陈万青,郑荣寿,张思维,等.2013年中国恶性肿瘤发病和死亡分析[J].中国肿瘤,2017,26(1):1-7.
[3]HOLCH J W,RICARD I,STINTZING S,et al.The relevance of primary tumor location in patients with metastatic colorectal cancer:a meta-analysis of first-line clinical trials[J].European Journal of Cancer,2017,70:87-98.
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[5]CHEN W,ZHENG R,BAADE P D,et al.Cancer statistics in China,2015[J].Ca Cancer J Clin,2016,66(2):115-132.
[6]胡俊杰,周志祥,梁建伟,等.左、右半结肠癌患者临床病理特点及预后差异分析[J].中华医学杂志,2015,95(28):2268-2271.
[7]韦金磊,张森.来自SEER数据库的左右半结肠癌临床病理特点及生存分析[J].结直肠肛门外科,2017,23(6):709-715.
[8]LIN J H,ZHANG S M,REXRODE K M,et al.Association between Sex hormones and colorectal cancer risk in men and women[J].Clin Gastroenterol Hepatol,2013,11(4):419-424.
[9]H?FFKEN N,LEICHSENRING J,REINACHER-SCHICK A.Clinically relevant,gender-specific differences in colorectal carcinoma(CRC)[J].Zeitschrift fur Gastroenterologie,2015,53(8):782-788.
[10]姚婷婷,郝吉庆.398例左、右半结肠癌患者的临床特点及生存分析[J].现代肿瘤医学,2018,26(13):2069-2072.
[11]殷放,陈凯,李怀富.左,右半结肠癌淋巴结转移的差异[J].中国实用医药,2010,5(12):59-60.
[12]王留伟.结肠癌淋巴结转移的相关因素分析[J].肿瘤基础与临床,2018,31(1):76-77.
[13]徐洪丽,胡俊杰,徐慧婷,等.不同原发部位结肠癌的临床病理及预后分析[J].肿瘤防治研究,2018,45(9):672-675.
[14]MESSICK C A,KRAVOCHUCK S,CHURCH J M,et al.Metachronous serrated neoplasia is uncommon after right colectomy in patients with methylator colon cancers with a high degree of microsatellite instability[J].Dis Colon Rectum,2014,57(1):39.
[15]张升瑞,隋春阳,赵连和.遗传性非息肉病性结直肠癌与散发性结肠癌的临床特征及生存率对比分析[J].医学研究生学报,2017,30(9):963-967.
[16]PETRELLI F,TOMASELLO G,BORGONOVO K,et al.Prognostic survival associated with left-sided vs right-sided colon cancer:a systematic review and Meta-analysis[J].Jama Oncology,2017,3(2):211-219.
[17]WEISS J M,PFAU P R,O’CONNOR E S,et al.Mortality by stage for right-versus left-sided colon cancer:analysis of surveillance,epidemiology,and end results-Medicare data[J].J of Clin Oncol,2011,29(33):4401.
[18]PRICE T J,BEEKE C,ULLAH S,et al.Does the primary site of colorectal cancer impact outcomes for patients with metastatic disease?[J].Cancer,2015,121(6):830-835.
[2]陈万青,郑荣寿,张思维,等.2013年中国恶性肿瘤发病和死亡分析[J].中国肿瘤,2017,26(1):1-7.
[3]HOLCH J W,RICARD I,STINTZING S,et al.The relevance of primary tumor location in patients with metastatic colorectal cancer:a meta-analysis of first-line clinical trials[J].European Journal of Cancer,2017,70:87-98.
[4]BUFILL J A.Colorectal cancer:evidence for distinct genetic categories based on proximal or distal tumor location[J].Annals of internal medicine,1990,113(10):779-788.
[5]CHEN W,ZHENG R,BAADE P D,et al.Cancer statistics in China,2015[J].Ca Cancer J Clin,2016,66(2):115-132.
[6]胡俊杰,周志祥,梁建伟,等.左、右半结肠癌患者临床病理特点及预后差异分析[J].中华医学杂志,2015,95(28):2268-2271.
[7]韦金磊,张森.来自SEER数据库的左右半结肠癌临床病理特点及生存分析[J].结直肠肛门外科,2017,23(6):709-715.
[8]LIN J H,ZHANG S M,REXRODE K M,et al.Association between Sex hormones and colorectal cancer risk in men and women[J].Clin Gastroenterol Hepatol,2013,11(4):419-424.
[9]H?FFKEN N,LEICHSENRING J,REINACHER-SCHICK A.Clinically relevant,gender-specific differences in colorectal carcinoma(CRC)[J].Zeitschrift fur Gastroenterologie,2015,53(8):782-788.
[10]姚婷婷,郝吉庆.398例左、右半结肠癌患者的临床特点及生存分析[J].现代肿瘤医学,2018,26(13):2069-2072.
[11]殷放,陈凯,李怀富.左,右半结肠癌淋巴结转移的差异[J].中国实用医药,2010,5(12):59-60.
[12]王留伟.结肠癌淋巴结转移的相关因素分析[J].肿瘤基础与临床,2018,31(1):76-77.
[13]徐洪丽,胡俊杰,徐慧婷,等.不同原发部位结肠癌的临床病理及预后分析[J].肿瘤防治研究,2018,45(9):672-675.
[14]MESSICK C A,KRAVOCHUCK S,CHURCH J M,et al.Metachronous serrated neoplasia is uncommon after right colectomy in patients with methylator colon cancers with a high degree of microsatellite instability[J].Dis Colon Rectum,2014,57(1):39.
[15]张升瑞,隋春阳,赵连和.遗传性非息肉病性结直肠癌与散发性结肠癌的临床特征及生存率对比分析[J].医学研究生学报,2017,30(9):963-967.
[16]PETRELLI F,TOMASELLO G,BORGONOVO K,et al.Prognostic survival associated with left-sided vs right-sided colon cancer:a systematic review and Meta-analysis[J].Jama Oncology,2017,3(2):211-219.
[17]WEISS J M,PFAU P R,O’CONNOR E S,et al.Mortality by stage for right-versus left-sided colon cancer:analysis of surveillance,epidemiology,and end results-Medicare data[J].J of Clin Oncol,2011,29(33):4401.
[18]PRICE T J,BEEKE C,ULLAH S,et al.Does the primary site of colorectal cancer impact outcomes for patients with metastatic disease?[J].Cancer,2015,121(6):830-835.