结肠和直肠黏液性及印戒细胞癌的10年预后评估

A 10-year outcomes evaluation of mucinous and signet-ring cell carcinoma of the colon and rectum.

作者信息

Kang Hakjung, O'Connell Jessica B, Maggard Melinda A, Sack Jonathan, Ko Clifford Y

机构信息

Department of Surgery, Daehang Hospital, Seoul, Korea.

出版信息

Dis Colon Rectum. 2005 Jun;48(6):1161-8. doi: 10.1007/s10350-004-0932-1.

DOI:10.1007/s10350-004-0932-1

PMID:15868237

Abstract

PURPOSE

Most studies examining mucinous or signet-ring cell colorectal cancers are single institution reports. This study used a national cancer registry to analyze the epidemiology and survival outcomes of these two subtypes of colorectal cancer compared with adenocarcinoma tumors.

METHODS

All patients diagnosed with mucinous (n = 16,991), signet-ring cell (n = 1,522), or adenocarcinoma (n = 146,115) colorectal cancer in the Surveillance, Epidemiology, and End Results database (1991-2000) were evaluated. Analyses were performed to obtain age-adjusted incidence rates, stage at presentation, tumor grade, and five-year relative survival for each subtype.

RESULTS

Mucinous were slightly more common in females (53.4 percent). Incidence rates per 100,000 persons were: mucinous, 5.5; signet-ring cell, 0.6; and adenocarcinoma 46.6. The annual percent change during ten years was stable for mucinous, increased for signet-ring cell (4.8 percent; P < 0.05), and decreased for adenocarcinoma (-1.1 percent; P < 0.05). Fewer mucinous (18 percent) and signet-ring cell (21 percent) tumors were located in the rectum compared with adenocarcinoma (29 percent). Signet-ring cell presented at later stage (III/IV, 80.9 percent) more often than mucinous (52.8 percent) and adenocarcinoma (49.5 percent), and also had worse tumor grade (high grade: signet-ring cell, 73.5 percent; mucinous, 20.9 percent; adenocarcinoma, 17.5 percent). Relative five-year survival was worse for signet-ring cell than mucinous or adenocarcinoma.

CONCLUSIONS

We present a large population-based review of colorectal cancer subtypes by analyzing national data from the past decade. Although the incidence of colorectal adenocarcinoma is decreasing in the United States, mucinous and signet-ring cell subtypes are stable and increasing, respectively. Importantly, it seems that the signet-ring cell subtype has worse outcomes, whereas survival rates for mucinous tumors are similar to adenocarcinomas.

摘要

目的

大多数关于黏液性或印戒细胞型结直肠癌的研究都是单机构报告。本研究利用国家癌症登记处分析这两种结直肠癌亚型与腺癌肿瘤相比的流行病学和生存结果。

方法

对监测、流行病学和最终结果数据库（1991 - 2000年）中所有诊断为黏液性（n = 16,991）、印戒细胞型（n = 1,522）或腺癌（n = 146,115）结直肠癌的患者进行评估。进行分析以获得每种亚型的年龄调整发病率、就诊时的分期、肿瘤分级和五年相对生存率。

结果

黏液性癌在女性中略为常见（53.4%）。每10万人的发病率分别为：黏液性癌5.5、印戒细胞癌0.6、腺癌46.6。十年间黏液性癌的年变化百分比稳定，印戒细胞癌增加（4.8%；P < 0.05），腺癌减少（-1.1%；P < 0.05）。与腺癌（29%）相比，位于直肠的黏液性癌（18%）和印戒细胞癌（21%）较少。印戒细胞癌比黏液性癌（52.8%）和腺癌（49.5%）更常处于晚期（III/IV期，80.9%），且肿瘤分级也更差（高级别：印戒细胞癌73.5%、黏液性癌20.9%、腺癌17.5%）。印戒细胞癌的五年相对生存率比黏液性癌或腺癌更差。