Gómez-Domínguez E, Trapero-Marugán M, del Pozo A J, Cantero J, Gisbert J P, Maté J
Service of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain.
Rev Esp Enferm Dig. 2006 May;98(5):322-9. doi: 10.4321/s1130-01082006000500002.
detection of early-stage colorectal carcinoma (CRC)--( Dukes A or B)--provides better survival rates in these patients. Thus, the effectiveness of screening programs in asymptomatic patients or of early diagnosis in symptomatic individuals has been postulated. The aim of this study was to establish whether a delay in diagnosis or other factors are related to CRC stage.
a retrospective study was performed on 96 patients with CRC. Age at diagnosis, gender distribution, intestinal disorders, diagnosis delay, primary sign and -regarding CRC- localization, stage (Dukes) and grade of differentiation (well differentiated; non-well differentiated; poorly differentiated) were recorded.
diagnosis delay was 185 +/- 190 days. Patients delay in obtaining a diagnosis was 119 +/- 158 days. In 40% of patients CRC was diagnosed at an early stage (Dukes A or B), and in 13% CRC was poorly differentiated. The only factor with an independent effect on Dukes stage was tumor differentiation (p: 0.0012). Distal location was associated with less advanced tumors without statistical significance (p: 0.156).
based on the presented data, a greater effort regarding screening programs for healthy people seems warranted, as improved survival has been demonstrated when diagnosis delay is reduced, particularly in patients with the highest mean delay.
早期结直肠癌(CRC)(杜克A期或B期)的检测能使这些患者获得更好的生存率。因此,有人推测了针对无症状患者的筛查计划或针对有症状个体的早期诊断的有效性。本研究的目的是确定诊断延迟或其他因素是否与结直肠癌分期有关。
对96例结直肠癌患者进行了一项回顾性研究。记录诊断时的年龄、性别分布、肠道疾病、诊断延迟、主要症状以及关于结直肠癌的定位、分期(杜克分期)和分化程度(高分化;非高分化;低分化)。
诊断延迟为185±190天。患者获得诊断的延迟为119±158天。40%的患者结直肠癌被诊断为早期(杜克A期或B期),13%的结直肠癌为低分化。对杜克分期有独立影响的唯一因素是肿瘤分化(p:0.0012)。远端部位与肿瘤进展程度较低相关,但无统计学意义(p:0.156)。
根据所提供的数据,似乎有必要加大对健康人群筛查计划的力度,因为当减少诊断延迟时,生存率已得到提高,尤其是在平均延迟时间最长的患者中。