印度的结直肠癌:来自低发病率地区一家三级中心的审计
Colorectal Cancer in India: An Audit from a Tertiary Center in a Low Prevalence Area.
作者信息
Patil Prachi S, Saklani Avanish, Gambhire Pravir, Mehta Shaesta, Engineer Reena, De'Souza Ashwin, Chopra Supriya, Bal Munita
机构信息
Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Dr Ernest Borges Road, Mumbai, 400012 India.
Department of Surgical Oncology, Tata Memorial Hospital, Dr Ernest Borges Road, Mumbai, 400012 India.
出版信息
Indian J Surg Oncol. 2017 Dec;8(4):484-490. doi: 10.1007/s13193-017-0655-0. Epub 2017 Apr 22.
Colorectal cancer (CRC) is a common cancer worldwide with a low reported incidence in India. There is significant geographical variation in the incidence rates, and the presentation may also vary. There are few studies evaluating the clinical profile of CRC in Indian patients. We analyzed a prospective database maintained at the Tata Memorial Hospital, a referral cancer center in Mumbai, of consecutive patients with CRC between August 2013 and August 2014. We captured details regarding the demography, symptoms, pathology, stage, and treatment plan. The aim was to assess the demographic and clinical details of patients with CRC in India and compare it with those of the reported literature. Eight hundred new patients with CRC were seen in the colorectal clinic in one year. The mean age was 47.2 years. Sixty-five percent were males. Patients were symptomatic for an average period of 4 months prior to presentation. The commonest symptoms were rectal bleeding (57%), pain (44%), and altered bowel habits (26%). Thirteen percent of the patients had signet ring tumors. The median CEA (carcinoembryonic antigen) level was 5.8 ng/mL. Most patients had localized or locally advanced disease. Twenty-eight percent of the patients had metastatic disease with liver being the commonest site of metastases (14%) followed by peritoneum and lung. More than half of the patients received treatment with a curative intent. Colorectal cancer in India differs from that described in the Western countries. We had more young patients, higher proportion of signet ring carcinomas, and more patients presenting with an advanced stage. Inadequate access to healthcare and socioeconomic factors may play a role in some of these differences.
结直肠癌(CRC)是一种全球常见的癌症,在印度报告的发病率较低。发病率存在显著的地理差异,临床表现也可能有所不同。评估印度患者结直肠癌临床特征的研究较少。我们分析了位于孟买的转诊癌症中心塔塔纪念医院维护的一个前瞻性数据库,该数据库收录了2013年8月至2014年8月期间连续的结直肠癌患者。我们收集了有关人口统计学、症状、病理、分期和治疗计划的详细信息。目的是评估印度结直肠癌患者的人口统计学和临床细节,并将其与已发表文献中的数据进行比较。一年内,结直肠门诊共接待了800名新的结直肠癌患者。平均年龄为47.2岁。65%为男性。患者在就诊前平均有4个月的症状期。最常见的症状是直肠出血(57%)、疼痛(44%)和排便习惯改变(26%)。13%的患者患有印戒细胞癌。癌胚抗原(CEA)水平的中位数为5.8 ng/mL。大多数患者患有局限性或局部晚期疾病。28%的患者有转移性疾病,肝脏是最常见的转移部位(14%),其次是腹膜和肺。超过一半的患者接受了旨在治愈的治疗。印度的结直肠癌与西方国家描述的不同。我们有更多的年轻患者、更高比例的印戒细胞癌以及更多处于晚期的患者。医疗保健服务获取不足和社会经济因素可能在其中一些差异中起作用。
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