1166例结直肠癌临床病理特征分析
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摘要
目的探讨吉林省延吉地区结直肠癌发病情况及临床病理特征。方法回顾分析2011年1月至2016年12月延边大学附属医院经手术后病理确诊的1 166例结直肠癌患者的病历资料。结果1 166例结直肠癌病理诊断主要为腺癌和黏液腺癌,男719例(61.7%)、女447例(38.3%),男女比例为1.61比1。>51岁为发病高峰,占88.7%;>70岁占32.9%。其中直肠癌占44.9%。青年患者(≤40岁)结直肠癌发生率比过去增高,与中老年结直肠癌患者相比,右半结肠癌发生率较高。组织学类型主要为中分化腺癌(86.6%)。淋巴结转移与肿瘤浸润深度和分化程度密切相关。结论吉林省延吉地区结直肠癌发病率呈增长趋势,患者就诊时多为中晚期。早发现、早诊断、早治疗可提高结直肠癌患者生存率。
Objective To study the clinicopathological characteristics of colorectal cancer in Yanji City of Jilin Province.Methods Statistical analysis was conducted in the 1 166 cases of colorectal malignancy treated in Yanbian University Hospital from January 2011 to December 2016.Results Most cases were histologically identified as adenocarcinoma and mucinous adenocarcinoma(1 166 cases).The patient cohort consisted of 719 males(61.7%) and 447 females(38.3%),with a male to female ratio of 1.61 ∶ 1.The high-risk age range for colorectal cancer was over 51 years(making up 88.7% of the total patients).The best predilection site of colorectal cancer was still rectum(44.9%).Compared with their seniors,young patients(age≤40) were prone to be affected by colorectal cancer.Histological type was mainly moderately differentiated adenocarcinoma(86.6%).Lymph node metastasis was closely related to the depth of tumor invasion and differentiation.Conclusions Colorectal cancer is increasing in this area,and most of the patients are in the middle and late stage.Colorectal cancer should be early detection,early diagnosis,and early treatment,so as to improve the survival rate of patients.
Objective To study the clinicopathological characteristics of colorectal cancer in Yanji City of Jilin Province.Methods Statistical analysis was conducted in the 1 166 cases of colorectal malignancy treated in Yanbian University Hospital from January 2011 to December 2016.Results Most cases were histologically identified as adenocarcinoma and mucinous adenocarcinoma(1 166 cases).The patient cohort consisted of 719 males(61.7%) and 447 females(38.3%),with a male to female ratio of 1.61 ∶ 1.The high-risk age range for colorectal cancer was over 51 years(making up 88.7% of the total patients).The best predilection site of colorectal cancer was still rectum(44.9%).Compared with their seniors,young patients(age≤40) were prone to be affected by colorectal cancer.Histological type was mainly moderately differentiated adenocarcinoma(86.6%).Lymph node metastasis was closely related to the depth of tumor invasion and differentiation.Conclusions Colorectal cancer is increasing in this area,and most of the patients are in the middle and late stage.Colorectal cancer should be early detection,early diagnosis,and early treatment,so as to improve the survival rate of patients.
引文
[1]来茂德,滕晓东,徐芳英.胃肠道病理研究的一些共识和争议[J].中华病理学杂志,2011,40(5):289-292.
[2]李道娟,李倩,贺宇彤.结直肠癌流行病学趋势[J].肿瘤防治研究,2015,42(3):305-310.
[3]任大宾,徐萍,赖跃兴,等.916例结直肠癌临床病理分析[J].四川医学,2016,37(2):127-130,131.
[4]陈琼,刘志才,程兰平,等.2003~2007年中国结直肠癌发病与死亡分析[J].中国肿瘤,2012,21(3):179-182.
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[7]al-Azzawi F,Wahab M.Estrogen and colon cancer:current issues[J].Climacteric,2002,5(1):3-14.
[8]Gilligan LC,Rahman HP,Hewitt AM,et al.Estrogen Activation by Steroid Sulfatase Increases Colorectal Cancer Proliferation via GPER[J].J Clin Endocrinol Metab,2017,102(12):4435-4447.
[9]Kotake K,Honjo S,Sugihara K,et al.Changes in colorectal cancer during a 20-year period:an extended report from the multiinstitutional registry of large bowel cancer,Japan[J].Dis Colon Rectum,2003,46(10 Suppl):S32-43.
[10]胡华元,姚艳梅,王捷鹏,等.广东惠东地区结直肠癌的发病特点[J].世界华人消化杂志,2011,19(11):1195-1198.
[11]Axtell LM,Chiazze L.Changing relative frequency of cancers of the colon and rectum in the United States[J].Cancer,1966,19(6):750-754.
[12]Suzuki T,Sadahiro S,Mukoyama S,et al.Risk of lymph node and distant metastases in patients with early invasive colorectal cancer classified as Haggitt's level 4 invasion:image analysis of submucosal layer invasion[J].Dis Colon Rectum,2003,46(2):203-208.
[13]黄小杏,黄世勇,谢伟.150例结直肠癌浸润深度与淋巴结转移情况的临床病理研究[J].中国当代医药,2013,20(33):4-6,10.
[14]陈万源,陈贤贵,楼荣灿.结直肠癌淋巴结转移规律的临床研究[J].癌症,2000,19(5):479.
[15]熊启敏,严文跃,胡静,等.原发性年轻结直肠癌患者的病理特征及预后分析[J].现代肿瘤医学,2018,26(6):888-892.
[16]彭志海,张放,周崇治,等.散发性结肠直肠癌肿瘤分化及转移相关基因杂合缺失分析[J].中华外科杂志,2002,40(10):776-779.
[17]孙华君,郑海涛,许洁,等.散发性结肠直肠癌4号染色体长臂的杂合缺失分析[J].中华肿瘤防治杂志,2008,15(17):1333-1335.
[18]Ansa BE,Coughlin SS,Alema-Mensah E,et al.Evaluation of Colorectal Cancer Incidence Trends in the United States(2000-2014)[J].J Clin Med,2018,7(2).
[2]李道娟,李倩,贺宇彤.结直肠癌流行病学趋势[J].肿瘤防治研究,2015,42(3):305-310.
[3]任大宾,徐萍,赖跃兴,等.916例结直肠癌临床病理分析[J].四川医学,2016,37(2):127-130,131.
[4]陈琼,刘志才,程兰平,等.2003~2007年中国结直肠癌发病与死亡分析[J].中国肿瘤,2012,21(3):179-182.
[5]Comstock SS,Hortos K,Kovan B,et al.Adipokines and obesity are associated with colorectal polyps in adult males:a cross-sectional study[J].PLoS One,2014,9(1):e85939.
[6]Park YM,Cho CH,Kim SH,et al.Alcohol intake,smoking,and colorectal adenoma[J].J Cancer Prev,2014,19(2):137-143.
[7]al-Azzawi F,Wahab M.Estrogen and colon cancer:current issues[J].Climacteric,2002,5(1):3-14.
[8]Gilligan LC,Rahman HP,Hewitt AM,et al.Estrogen Activation by Steroid Sulfatase Increases Colorectal Cancer Proliferation via GPER[J].J Clin Endocrinol Metab,2017,102(12):4435-4447.
[9]Kotake K,Honjo S,Sugihara K,et al.Changes in colorectal cancer during a 20-year period:an extended report from the multiinstitutional registry of large bowel cancer,Japan[J].Dis Colon Rectum,2003,46(10 Suppl):S32-43.
[10]胡华元,姚艳梅,王捷鹏,等.广东惠东地区结直肠癌的发病特点[J].世界华人消化杂志,2011,19(11):1195-1198.
[11]Axtell LM,Chiazze L.Changing relative frequency of cancers of the colon and rectum in the United States[J].Cancer,1966,19(6):750-754.
[12]Suzuki T,Sadahiro S,Mukoyama S,et al.Risk of lymph node and distant metastases in patients with early invasive colorectal cancer classified as Haggitt's level 4 invasion:image analysis of submucosal layer invasion[J].Dis Colon Rectum,2003,46(2):203-208.
[13]黄小杏,黄世勇,谢伟.150例结直肠癌浸润深度与淋巴结转移情况的临床病理研究[J].中国当代医药,2013,20(33):4-6,10.
[14]陈万源,陈贤贵,楼荣灿.结直肠癌淋巴结转移规律的临床研究[J].癌症,2000,19(5):479.
[15]熊启敏,严文跃,胡静,等.原发性年轻结直肠癌患者的病理特征及预后分析[J].现代肿瘤医学,2018,26(6):888-892.
[16]彭志海,张放,周崇治,等.散发性结肠直肠癌肿瘤分化及转移相关基因杂合缺失分析[J].中华外科杂志,2002,40(10):776-779.
[17]孙华君,郑海涛,许洁,等.散发性结肠直肠癌4号染色体长臂的杂合缺失分析[J].中华肿瘤防治杂志,2008,15(17):1333-1335.
[18]Ansa BE,Coughlin SS,Alema-Mensah E,et al.Evaluation of Colorectal Cancer Incidence Trends in the United States(2000-2014)[J].J Clin Med,2018,7(2).