Fazeli Mohhamad S, Adel Maryam Ghavami, Lebaschi Amir H
Department of General Surgery, Imam Medical Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, P. O. Box 13145-158, Tehran, Iran.
Dis Colon Rectum. 2007 Jul;50(7):990-5. doi: 10.1007/s10350-007-0248-z.
Colorectal carcinoma is one of the most common cancers in the world as well as in Iran. There are differences in subsite of the carcinoma when considering age and gender. This study was designed to describe the distribution of colorectal carcinoma by age at diagnosis, gender, and subsite of the tumor. These factors also are evaluated in conjunction with disease stage and tumor differentiation at the time of diagnosis.
Data from 419 patients from a population that receives no screening between April 1995 and March 2001 operated on in the Cancer Institute and Imam Khomieni Hospital with a diagnosis of colorectal cancer were used to describe distribution of the colorectal carcinoma by age, gender, tumor subsite and pathology, and stage at diagnosis.
There were 403 (96.2 percent) cases of adenocarcinoma. Males and females constituted 52.4 and 47.6 percent of cases, respectively. The mean age was 52.3 years. Patients were divided into two age groups (40 years and younger, and older than 40 years); 16.4 percent of patients had tumors in the proximal colon and 83.6 percent in distal parts. Most patients were Stage II and III (48.1 and 33.4 percent, respectively). Tumor subsite distribution was almost the same between the two age groups (aged 40 years and younger: proximal, 18.5 percent, and distal, 81.5 percent; older than aged 40 years: proximal, 15.7 percent, and distal, 84.3 percent). Most patients in the younger age group were Stage III (45 percent) and in the older age group were Stage II (53.2 percent; P<0.001). Tumor differentiation proportions in patients aged 40 years and younger were: good, 24.4 percent; moderate, 53.6 percent; poor, 22 percent; and in patients older than aged 40 years were: good, 41.5 percent; moderate, 52.6 percent; poor, 5.9 percent (P<0.001). There were no differences in stage and tumor differentiation between two genders, but most of the patients with tumors in proximal colon were males (62.5 percent; P=0.1).
Most of the colorectal carcinomas were in distal parts in our study, so most of these carcinomas can be detected by proctosigmoidoscopy. Because younger patients had more advanced disease, the importance of screening and "clinical suspicion" in the young is important.
结直肠癌是世界以及伊朗最常见的癌症之一。在考虑年龄和性别时，癌的亚部位存在差异。本研究旨在描述结直肠癌按诊断时年龄、性别及肿瘤亚部位的分布情况。这些因素还将结合诊断时的疾病分期和肿瘤分化情况进行评估。
使用1995年4月至2001年3月期间在癌症研究所和伊玛目霍梅尼医院接受手术、诊断为结直肠癌且未接受筛查人群中的419例患者的数据，来描述结直肠癌按年龄、性别、肿瘤亚部位、病理及诊断分期的分布情况。
腺癌病例有403例（96.2%）。男性和女性分别占病例的52.4%和47.6%。平均年龄为52.3岁。患者被分为两个年龄组（40岁及以下和40岁以上）；16.4%的患者肿瘤位于近端结肠，83.6%位于远端。大多数患者为Ⅱ期和Ⅲ期（分别为48.1%和33.4%）。两个年龄组之间肿瘤亚部位分布几乎相同（40岁及以下组：近端，18.5%，远端，81.5%；40岁以上组：近端，15.7%，远端，84.3%）。较年轻年龄组的大多数患者为Ⅲ期（45%），而较年长年龄组的大多数患者为Ⅱ期（53.2%；P<0.001）。40岁及以下患者的肿瘤分化比例为：高分化，24.4%；中分化，53.6%；低分化，22%；40岁以上患者的肿瘤分化比例为：高分化，41.5%；中分化，52.6%；低分化，5.9%（P<0.001）。两性之间在分期和肿瘤分化方面无差异，但近端结肠有肿瘤的大多数患者为男性（62.5%；P=0.1）。
在我们的研究中，大多数结直肠癌位于远端，因此这些癌中的大多数可通过直肠乙状结肠镜检查检测到。由于年轻患者的疾病更晚期，所以对年轻人进行筛查和“临床怀疑”很重要。
