Stelzner F
Chirurgische Universitätsklinik Bonn, Deutschland.
Chirurg. 2012 Aug;83(8):726-31. doi: 10.1007/s00104-011-2236-z.
The distribution curves of grades of malignancy for colorectal carcinomas and pancreatic carcinomas have not been stable over the years and investigations have shown a clear variability in the temporal distribution. Colon carcinomas were found to diminish considerably in aggressiveness in different time periods and colorectal carcinomas were found to increase in aggressiveness in some years. However, the distribution curve of grades of malignancy varies in both carcinomas over time and this variation follows a random distribution. In contrast to colorectal carcinomas, pancreatic carcinomas have not been followed up for very long time periods. While the distribution curve of malignancy was unchanged in most countries an increase in malignancy was observed in two countries. For colorectal and pancreatic carcinomas increases in malignancy are linked to a highly significant decrease in the number of cancers with lowest grades of malignancy. Even though the exact nature of variations in these malignancy distribution curves is incompletely understood, these variations appear important for comparative outcome statistics in cancer therapy as the aggressiveness of these malignancies has a direct bearing on the overall prognosis.
多年来，结直肠癌和胰腺癌的恶性程度分布曲线并不稳定，调查显示其时间分布存在明显变异性。研究发现，在不同时间段，结肠癌的侵袭性显著降低，而在某些年份，结直肠癌的侵袭性则有所增加。然而，这两种癌症的恶性程度分布曲线随时间变化，且这种变化呈随机分布。与结直肠癌不同，胰腺癌的随访时间不长。虽然在大多数国家，恶性程度分布曲线没有变化，但在两个国家观察到恶性程度有所增加。对于结直肠癌和胰腺癌，恶性程度的增加与恶性程度最低的癌症数量的显著减少有关。尽管这些恶性程度分布曲线变化的确切性质尚未完全明了，但这些变化对于癌症治疗的比较结果统计似乎很重要，因为这些恶性肿瘤的侵袭性直接关系到总体预后。
