Yang Xue-Feng, Zhang Ji-Feng, Li Jun-Jun, Zhao Shuang, Shi Shuai, Wu Ji-Cheng, Fang Lei, Jiang Hua-Mao, Zheng Hua-Chuan
Cancer Center, Key Laboratory of Brain and Spinal Cord Injury of Liaoning Province, and Animal Center, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121001, China.
Department of Urology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121001, China.
Oncotarget. 2016 Dec 20;7(51):84155-84164. doi: 10.18632/oncotarget.12228.
Here, we collected the information of 17304 and 2014 inpatients with colorectal cancer (CRC) from general hospitals of China and Japan respectively, and analyzed microscopic and macroscopic aspects, even stratified by the age and gender. It was found that Chinese CRC patients showed younger prone, more rectal and ascending cancers, less sigmoid and transverse cancers, larger size, less invasion into lymphatic system or metastasis into lymph node, and poorer differentiation than Japanese ones (p < 0.05). TNM staging was employed as an independent factor for the prognosis of the CRC patients regardless of the country (p < 0.05). Female patients showed larger tumor size, easier invasion and metastasis into lymphatic system, and worse differentiation than males (p < 0.05). The younger patients displayed frequent invasion and metastasis into lymphatic system, and poor differentiation in comparison to elder ones (p < 0.05). These findings demonstrated that Japanese patients seemed to have more invasion and metastasis due to standard and precise operation and pathological diagnosis accuracy. Actually, Chinese patients had more aggressive pathological characteristics and a poorer prognosis. Therefore, it is essential to establish a routine screening methodology, a standard treatment system and postoperative diagnosis protocol for the prevention and therapeutics of Chinese CRC patients, especially for female and young patients.
在此,我们分别收集了来自中国和日本综合医院的17304例和2014例结直肠癌(CRC)住院患者的信息,并从微观和宏观方面进行了分析,甚至按年龄和性别进行了分层。结果发现,中国CRC患者比日本患者发病年龄更年轻,直肠癌和升结肠癌更多,乙状结肠癌和横结肠癌更少,肿瘤尺寸更大,侵犯淋巴系统或发生淋巴结转移的情况更少,分化程度更差(p<0.05)。无论来自哪个国家,TNM分期都是CRC患者预后的独立影响因素(p<0.05)。女性患者的肿瘤尺寸更大,更容易侵犯和转移至淋巴系统,分化程度比男性更差(p<0.05)。与老年患者相比,年轻患者侵犯和转移至淋巴系统的情况更频繁,分化程度更差(p<0.05)。这些发现表明,由于手术规范精确且病理诊断准确,日本患者似乎侵袭和转移情况更多。实际上,中国患者具有更具侵袭性的病理特征和更差的预后。因此,为中国CRC患者,尤其是女性和年轻患者的预防和治疗建立常规筛查方法、标准治疗体系和术后诊断方案至关重要。