Heimann T M, Oh S C, Martinelli G, Szporn A, Luppescu N, Lembo C A, Kurtz R J, Fasy T M, Greenstein A J
Department of Surgery, Mount Sinai School of Medicine, City University of New York, New York 10029.
Am J Surg. 1992 Jul;164(1):13-7. doi: 10.1016/s0002-9610(05)80638-5.
Fifty-two patients with ulcerative colitis and colorectal cancer undergoing colectomy at the Mount Sinai Hospital between 1973 and 1988 were studied retrospectively to determine the correlation of age, sex, duration of colitis, tumor location, number of cancers, tumor differentiation, colloid content, presence of signet ring cells, Dukes' classification, and DNA ploidy with survival. The mean age was 45 years, with a mean duration of colitis of 21 years. Five patients (10%) had Dukes' A lesions, 17 (33%) had Dukes' B lesions, 17 (33%) had Dukes' C lesions, and 13 (25%) had distant metastases. Thirty patients (58%) had well- or moderately differentiated tumors, whereas tumors were poorly differentiated in 22 (42%). Twenty-eight patients (54%) had colloid tumors, and, in 14 (27%), signet ring cells were present. Thirty-one patients (60%) had nondiploid tumors. Actuarial analysis revealed that the 5-year survival rate was significantly worse for patients with nondiploid tumors (76% versus 32%). When stratified by stage, only patients with Dukes' C lesions showed a significant difference in survival for diploid versus nondiploid tumors. Multivariate analysis showed that the Dukes' classification was the best prognostic indicator, followed by tumor differentiation and DNA ploidy. Tumor location, colloid content, number of cancers, duration of disease, age, and sex did not correlate with the prognosis.
对1973年至1988年间在西奈山医院接受结肠切除术的52例溃疡性结肠炎合并结直肠癌患者进行回顾性研究，以确定年龄、性别、结肠炎病程、肿瘤位置、癌症数量、肿瘤分化程度、黏液含量、印戒细胞的存在、Dukes分期和DNA倍体与生存率的相关性。平均年龄为45岁，平均结肠炎病程为21年。5例（10%）患者为Dukes A期病变，17例（33%）为Dukes B期病变，17例（33%）为Dukes C期病变，13例（25%）有远处转移。30例（58%）患者的肿瘤为高分化或中分化，而22例（42%）患者的肿瘤为低分化。28例（54%）患者有黏液性肿瘤，14例（27%）患者存在印戒细胞。31例（60%）患者有非二倍体肿瘤。精算分析显示，非二倍体肿瘤患者的5年生存率明显较差（76%对32%）。按分期分层时，只有Dukes C期病变的患者在二倍体和非二倍体肿瘤的生存率上有显著差异。多变量分析显示，Dukes分期是最佳的预后指标，其次是肿瘤分化程度和DNA倍体。肿瘤位置、黏液含量、癌症数量、病程、年龄和性别与预后无关。
