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I-III期非转移性结肠癌患者的症状表现与分期、分级及术后3年死亡率的关系。

The relation of presenting symptoms with staging, grading, and postoperative 3-year mortality in patients with stage I-III non-metastatic colon cancer.

作者信息

Bedir Osman, Kızıltaş Şafak, Köstek Osman, Özkanlı Şeyma

机构信息

Department of Internal Medicine, İstanbul Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey.

出版信息

Turk J Gastroenterol. 2016 May;27(3):239-45. doi: 10.5152/tjg.2016.15508.

Abstract

BACKGROUND/AIMS: To evaluate the association of presenting symptoms with staging, grading, and postoperative 3-year mortality in patients with colon cancer.

MATERIALS AND METHODS

A total of 132 patients-with a mean (standard deviation; SD) age of 63.0 (10.0) years and of whom 56.0% were males-with non-metastatic stage I-III colon cancer were included. Symptoms prior to diagnosis were evaluated with respect to tumor localization, tumor node metastasis (TNM) stage, histological grade, and postoperative 3-year mortality.

RESULTS

Constipation and abdominal pain were the two most common symptoms appearing first (29.5% and 16.7%, respectively) and remained most predominant (25.0% and 20.0%, respectively) up to diagnosis. The frequency of admission symptoms significantly differed with respect to tumor location, TNM stage and histological grade. The postoperative 3-year survival rate was 61.4%. Multivariate logistic regression revealed that melena and rectal bleeding increased the likelihood of 3-year mortality by 13.6-fold (p=0.001) and 4.08-fold (p=0.011), respectively.

CONCLUSION

Our findings revealed differences in presenting symptom profiles with respect to the time of manifestation and predominance as well as to the TNM stage, histological grade, and tumor location. Given that melena and rectal bleeding increased the 3-year mortality risk by 13.6-fold and 4.08-fold, respectively, our findings indicate the association of admission symptoms with outcome among patients with colon cancer.

摘要

背景/目的:评估结肠癌患者的首发症状与分期、分级及术后3年死亡率之间的关联。

材料与方法

纳入132例非转移性I-III期结肠癌患者,平均(标准差;SD)年龄63.0(10.0)岁,其中56.0%为男性。对诊断前的症状进行评估,分析其与肿瘤定位、肿瘤淋巴结转移(TNM)分期、组织学分级及术后3年死亡率的关系。

结果

便秘和腹痛是最常见的首发症状(分别为29.5%和16.7%),直至诊断时仍最为突出(分别为25.0%和20.0%)。入院症状的频率在肿瘤位置、TNM分期和组织学分级方面存在显著差异。术后3年生存率为61.4%。多因素逻辑回归分析显示,黑便和直肠出血使3年死亡率增加的可能性分别为13.6倍(p=0.001)和4.08倍(p=0.011)。

结论

我们的研究结果揭示了首发症状在出现时间、突出程度以及TNM分期、组织学分级和肿瘤位置方面的差异。鉴于黑便和直肠出血分别使3年死亡风险增加13.6倍和4.08倍,我们的研究结果表明结肠癌患者的入院症状与预后相关。

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