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分析位于不同解剖部位的 1315 例结直肠癌的临床病理特征和预后。

Analysis of clinicopathological features and prognosis of 1315 cases in colorectal cancer located at different anatomical subsites.

机构信息

Department of Gastrointestinal Surgery, Second Affiliated Hospital of Dalian Medical University, NO. 467, Zhongshan Road, Dalian, 116023, China.

Department of Clinical Biochemistry, College of Laboratory Diagnostic Medicine, Dalian Medical University, NO. 9, Lvshun South Road, Dalian, 116044, China.

出版信息

Pathol Res Pract. 2019 Oct;215(10):152560. doi: 10.1016/j.prp.2019.152560. Epub 2019 Jul 23.

Abstract

PURPOSE

Compare and analyze the clinicopathological features and prognosis of 1315 patients with colorectal cancer located at different anatomical subsites.

METHODS

A retrospective study was conducted to analyze the clinicopathological features and prognosis from 1315 patients with colorectal cancer who underwent surgery in the department of gastrointestinal surgery at the Second Affiliated Hospital of Dalian Medical University from January 2013 to January 2019. Among them, 287 patients were divided into the right-sided colon cancer (RCC) group; 329 patients were included into the left-sided colon cancer (LCC) group and the remaining 699 patients were assigned to the rectal cancer (RC) group. Clinicopathological features such as gender, age, pathological differentiation, neurovascular invasion, TNM stage, related tumor markers, maximum tumor diameter (MTD), median survival time and overall survival rate were extracted and analyzed.

RESULTS

Patients in the RCC group had the oldest age of onset, highest positive rate of serum CA199 and greatest number of poorly differentiated adenocarcinomas among the three groups and significant statistical differences were found. The RC group had the highest positive rate of vascular invasion (42.9%) and the greatest number of patients in stage I and IV (19% and 3.9%, respectively). Besides, the number of patients with stage T1-T2 adenocarcinoma in RC group was also the highest among the three groups. There were no significant differences in gender, perineural invasion as well as serum levels of CEA, CA724 and CA242. The median survival time of RCC, LCC and RC were 72, 70 and 73 months, respectively, with significant inter-group differences (P = 0.049).

CONCLUSION

The age of onset of right-sided colon cancer is the oldest on average and poorly differentiated tumors accounted for the highest proportion. Besides, average maximum tumor diameter is the largest in right-sided colon cancer. In terms of median survival time, LCC is worse than RCC and RC. Colorectal cancer at different anatomical subsites has different epidemiological, clinicopathological features and prognosis. Fully understanding the clinicopathological features of colorectal cancer at different anatomical subsites is of certain guiding significance for the clinical diagnosis and treatment of colorectal cancer, and is conducive to individualized treatment and accurate treatment.

摘要

目的

比较并分析 1315 例结直肠不同解剖部位肿瘤患者的临床病理特征和预后。

方法

回顾性分析 2013 年 1 月至 2019 年 1 月大连医科大学第二附属医院胃肠外科收治的 1315 例结直肠癌患者的临床病理特征和预后。其中 287 例患者被分为右半结肠癌(RCC)组,329 例患者分为左半结肠癌(LCC)组,其余 699 例患者分为直肠癌(RC)组。提取并分析了性别、年龄、病理分化、神经血管侵犯、TNM 分期、相关肿瘤标志物、最大肿瘤直径(MTD)、中位生存时间和总生存率等临床病理特征。

结果

RCC 组患者发病年龄最大,CA199 血清阳性率最高,低分化腺癌比例最大,与其他两组相比差异均有统计学意义。RC 组血管侵犯阳性率最高(42.9%),I 期和 IV 期患者比例最高(分别为 19%和 3.9%)。此外,RC 组 T1-T2 期腺癌患者比例也最高。性别、神经周围侵犯、CEA、CA724 和 CA242 血清水平在三组间差异均无统计学意义。RCC、LCC 和 RC 的中位生存时间分别为 72、70 和 73 个月,组间差异有统计学意义(P=0.049)。

结论

右半结肠癌的发病年龄最大,低分化肿瘤比例最高。此外,右半结肠癌的平均最大肿瘤直径最大。在中位生存时间方面,LCC 比 RCC 和 RC 差。不同解剖部位的结直肠癌具有不同的流行病学、临床病理特征和预后。充分了解结直肠不同解剖部位的临床病理特征,对结直肠癌的临床诊断和治疗具有一定的指导意义,有利于个体化治疗和精准治疗。

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