低发人群大肠腺癌的临床病理特征。

Clinicopathological aspects of adenocarcinoma of the large bowel in a low incidence population.

机构信息

Department of Surgery, University of Ghana Medical School, Korle Bu, Accra, Ghana.

出版信息

J Surg Oncol. 2014 Mar;109(3):245-9. doi: 10.1002/jso.23489. Epub 2013 Nov 19.

DOI:10.1002/jso.23489

PMID:24249202

Abstract

BACKGROUND AND OBJECTIVES

The presentation of the different histopathologic subtypes of adenocarcinoma of the large bowel vary within the colorectum and appears to impact on treatment. This study evaluated the relationships between the clinical features of adenocarcinoma of the large bowel, the histopathologic subtypes, and treatment.

METHODS

Patients with adenocarcinoma of the large bowel presenting to the Korle Bu Teaching Hospital from January 1997 to December 2011 were studied.

RESULTS

The study involved 579 patients: 310 (53.5%) males and 269 (46.5%) females, median age 58 years. Right colon cancers were 170 (29.4%), left colon 128 (22.1%), and rectum 281 (48.5%). Well-differentiated cancers were 254 (43.3%), moderately differentiated 178 (30.3%), mucinous 90 (14.8%), anaplastic 44 (7.5%), and signet-ring cell cancer 13 (2.2%). The mean ages across the histologic types were unequal, F-test 8.34, P-value 0.0005, with patients with mucinous and signet-ring cancers much younger. Mucinous cancers were predominantly in the right colon while signet-ring cell cancers were mostly in the rectum. Well- and moderately differentiated cancers presented at early stage than anaplastic and signet-ring cell cancers, P ∼ 0.01 and P < 0.03, respectively. The overall resection rate was 346 (59.8%) with rectal cancer having very low resection rate of 81 (28.8%).

CONCLUSION

Adenocarcinoma of the large bowel was predominantly in the rectum and in patients who were 50 years and older and were mostly well or moderately differentiated cancers.

摘要

背景与目的

结直肠不同部位的大肠腺癌的组织病理学亚型表现不同，且似乎会影响治疗。本研究评估了大肠腺癌的临床特征、组织病理学亚型和治疗之间的关系。

方法

研究对象为 1997 年 1 月至 2011 年 12 月在科勒布教学医院就诊的大肠腺癌患者。

结果

本研究共纳入 579 例患者：男性 310 例（53.5%），女性 269 例（46.5%），中位年龄 58 岁。右半结肠癌 170 例（29.4%），左半结肠癌 128 例（22.1%），直肠癌 281 例（48.5%）。高分化癌 254 例（43.3%），中分化癌 178 例（30.3%），黏液腺癌 90 例（14.8%），未分化癌 44 例（7.5%），印戒细胞癌 13 例（2.2%）。不同组织学类型的平均年龄不均衡，F 检验 8.34，P 值 0.0005，黏液腺癌和印戒细胞癌患者的年龄明显更小。黏液腺癌主要位于右半结肠，而印戒细胞癌主要位于直肠。高分化和中分化癌的分期早于未分化癌和印戒细胞癌，P 值分别为 0.01 和 0.03。总的切除率为 346 例（59.8%），直肠癌的切除率非常低，仅为 81 例（28.8%）。