Division of Colorectal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China.
Division of Colorectal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China.
Clin Colorectal Cancer. 2018 Mar;17(1):e39-e44. doi: 10.1016/j.clcc.2017.06.010. Epub 2017 Jul 8.
The objective of the study was to investigate the clinicopathological features of primary colorectal signet-ring cell carcinoma. We retrospectively analyzed the clinical and survival data of 37 patients with primary colorectal signet-ring cell carcinoma. The mean survival time of patients in stage II, III, and IV were estimated using Student t test and the cumulative survival rates were estimated according to the method of Kaplan-Meier. The significance of the differences in survival rates were calculated using the log rank test. The incidence of primary colorectal signet-ring cell carcinoma was 1.40%, the median age of 37 patients was 50 years, the male to female ratio was 1.47:1, and 21 patients (56.8%) received a radical resection. Most patients 33 (89.2%) had an advanced tumor stage at the time of diagnosis (17 patients 45.9% stage III and 16 patients 43.2% stage IV), 34 (94.5%) patients showed a tumor depth of >T3, lymph node involvement occurred in 26 patients (70.3%), patients had a high incidence of peritoneal metastasis (16 patients 43.2% at presentation, 30 patients 81.1% at presentation and recurrence) and a low incidence of liver metastases (1 patients 2.7% at presentation, 5 patients 13.5% at presentation and recurrence). The 5-year survival rate after the initial surgery was 10.8%, the mean survival time of 37 patients was 27.1 ± 3.3 months, the mean survival time of patients in stage II, III, and IV were 47.0 ± 12.8 months, 37.1 ± 3.9 months, and 10.5 ± 1.4 months, respectively (P < .000). Colorectal signet-ring cell carcinoma is a rare neoplasm with a predominance in men. Its characteristic features were the advanced stage at the time of diagnosis, a high incidence of peritoneal metastases, a low incidence of liver metastasis, and a poor prognosis.
本研究旨在探讨原发性结直肠印戒细胞癌的临床病理特征。我们回顾性分析了 37 例原发性结直肠印戒细胞癌患者的临床和生存数据。采用 Student t 检验估计Ⅱ期、Ⅲ期和Ⅳ期患者的平均生存时间，并采用 Kaplan-Meier 法估计累积生存率。采用对数秩检验计算生存率差异的显著性。原发性结直肠印戒细胞癌的发病率为 1.40%，37 例患者的中位年龄为 50 岁，男女比例为 1.47:1，21 例（56.8%）患者接受根治性切除术。大多数患者（89.2%）在诊断时处于晚期肿瘤阶段（17 例患者 45.9%为Ⅲ期，16 例患者 43.2%为Ⅳ期），33 例（94.5%）患者肿瘤深度>T3，26 例（70.3%）患者发生淋巴结受累，患者腹膜转移发生率高（16 例患者首发时为 43.2%，30 例患者首发及复发时为 81.1%），肝转移发生率低（首发时 1 例为 2.7%，首发及复发时 5 例为 13.5%）。初始手术后的 5 年生存率为 10.8%，37 例患者的平均生存时间为 27.1±3.3 个月，Ⅱ期、Ⅲ期和Ⅳ期患者的平均生存时间分别为 47.0±12.8 个月、37.1±3.9 个月和 10.5±1.4 个月（P<0.000）。结直肠印戒细胞癌是一种罕见的肿瘤，男性居多。其特征为诊断时为晚期、腹膜转移发生率高、肝转移发生率低、预后差。
