Celestino A, Castillo T, Frisancho O, Contardo C, Espejo H, Tomioka C, Navarrete J
Servicio de Gastroenterología, HNERM-IPSS. Facultad de Medicina de la Universidad mayor de San Marcos, Lima, Perú.
Rev Gastroenterol Peru. 1996 Sep-Dec;16(3):187-96.
We report a clinic-endoscopical study about 365 patients, both of sex, between 26-95 years old, with colonoscopic diagnosis of colorectal cancer. Results showed that 61,92% were men and 38,08% women; in 92,60% the disease ocurred over 40 years old. 13,42% had malignant personal history -colorectal cancer, uterus and breast cancer, and others-; 13,97% had bening personal history-colorectal adenoma, cholecystectomy, and others-; Abdomina pain, change in intestinal habits, and bleeding were the moist frequent symptoms, with differences depending of the tumors localization in the colon or rectum. 62,57% of patients had anemia under 10g% of hernoglobin; in 85,23% the fecal occult blood test was positive. On 199 patients, the simple barium enema diagnosed the tumor in 66,33% only; but in the same group, colonoscopy diagnosed the cancer in 96,49% at first examination. In all patients, colonoscopywas excellent for diagnosis of the principal lesion, and for the identification of synchronous neoplasia. On 365 patients, colonoscopy diagnosed the cancer in 98,08% at first examination. The localization of tumors was: 57,63% in left colon (49,47% in rectum and sigmoid colon); 34,21% in the right colon; and 8,16% in transverse. Pathology showed that adenocarcinoma was the most frequent tumor 95,23%; 1,06% mucoid carcinoma; 1,06% epidermoid carcinoma; and 2,65% lymphorna. In 32,05% of cases there were synchronous lesions; 3,01% had other cancer, and 54 patients had 112 polyps (62,50% adenomatous polyp, 6,25% adenoma with non invasive or invasive adenocarcinoma, and 31,25% hiperplastic polyp. Authors emphasize the value of the detection and early diagnosis to decrese the colorectal cancer mortality.
我们报告了一项针对365例年龄在26至95岁之间、患有经结肠镜诊断为结直肠癌的患者的临床内镜研究。结果显示,男性占61.92%,女性占38.08%;92.60%的患者发病年龄超过40岁。13.42%有恶性个人病史——结直肠癌、子宫癌、乳腺癌等;13.97%有良性个人病史——结直肠腺瘤、胆囊切除术等;腹痛、肠道习惯改变和出血是最常见的症状,根据肿瘤在结肠或直肠的位置不同而有所差异。62.57%的患者血红蛋白低于10g%时出现贫血;85.23%的患者粪便潜血试验呈阳性。在199例患者中,单纯钡灌肠仅在66.33%的病例中诊断出肿瘤;但在同一组中,结肠镜检查在首次检查时诊断出癌症的比例为96.49%。在所有患者中,结肠镜检查对于主要病变的诊断以及同步肿瘤的识别都非常出色。在365例患者中,结肠镜检查在首次检查时诊断出癌症的比例为98.08%。肿瘤的定位情况为:左半结肠占57.63%(直肠和乙状结肠占49.47%);右半结肠占34.21%;横结肠占8.16%。病理显示腺癌是最常见的肿瘤,占95.23%;黏液癌占1.06%;表皮样癌占1.06%;淋巴瘤占2.65%。32.05%的病例存在同步病变;3.01%患有其他癌症,54例患者有112个息肉(62.50%为腺瘤性息肉,6.25%为伴有非侵袭性或侵袭性腺癌的腺瘤,31.25%为增生性息肉)。作者强调检测和早期诊断对于降低结直肠癌死亡率的价值。