Sauter Matthias, Keilholz Georg, Kranzbühler Helmut, Lombriser Norbert, Prakash Meher, Vavricka Stephan R, Misselwitz Benjamin
Department of Medicine and Specialities, Triemli Hospital, Zurich, Switzerland.
Division of Gastroenterology and Hepatology, University Hospital Zurich, Rämistr 100, 8091, Zürich, Switzerland.
BMC Gastroenterol. 2016 Apr 6;16:46. doi: 10.1186/s12876-016-0461-0.
Incidence of anal carcinoma (AC) is increasing and timely diagnosis is critical for efficient therapy. However, there is a paucity of recent studies addressing clinical symptoms and physical findings of anal carcinoma.
We performed a retrospective study reviewing history, symptoms and physical findings from 86 patients with newly diagnosed AC. We analyzed frequency of symptoms and physical findings according to T and TNM stage and their predictive value regarding tumor stage.
Most patients presented with T2 (37 %) or T3 (29 %) cancer. 85 of 86 patients were symptomatic with anal bleeding (78 %), anal/perianal pain (63 %), weight loss (31 %) and foreign body sensation (22 %). 95 % of patients had ≥1 finding on physical examination including a visible tumor, palpable resistance and pain/blood during digital rectal examination. Patients with locally advanced disease (T3/T4) presented with more symptoms (p < 0.01) and more physical findings (p = 0.04) than patients with T1/T2 disease. On multivariate regression analysis perianal pain, painful defecation and weight loss were significantly associated with T3/T4 disease.
Clinical symptoms and physical findings are present in nearly all AC patients. Pain referred to the perianal region, painful defecation and weight loss have predictive value for locally advanced disease.
肛管癌（AC）的发病率正在上升，及时诊断对于有效治疗至关重要。然而，近期针对肛管癌临床症状和体格检查结果的研究较少。
我们进行了一项回顾性研究，回顾了86例新诊断为肛管癌患者的病史、症状和体格检查结果。我们根据T分期和TNM分期分析了症状和体格检查结果的频率及其对肿瘤分期的预测价值。
大多数患者为T2期（37%）或T3期（29%）癌症。86例患者中有85例出现症状，包括肛门出血（78%）、肛门/肛周疼痛（63%）、体重减轻（31%）和异物感（22%）。95%的患者在体格检查中有≥1项发现，包括可见肿瘤、可触及的阻力以及直肠指检时的疼痛/出血。与T1/T2期疾病患者相比，局部晚期疾病（T3/T4）患者出现更多症状（p < 0.01）和更多体格检查发现（p = 0.04）。多因素回归分析显示，肛周疼痛、排便疼痛和体重减轻与T3/T4期疾病显著相关。
几乎所有肛管癌患者都有临床症状和体格检查发现。肛周区域疼痛、排便疼痛和体重减轻对局部晚期疾病具有预测价值。
