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50岁以下患者的结直肠癌:五年经验

Colorectal cancer in patients under age 50: a five-year experience.

作者信息

Silva Fernando Marinho Marques DA, Duarte Roberta Paiva, Leão Cássio César Arrais, Vissoci Carolina Martins, Alvarenga Amanda Luíza Aguiar Taquary, Ramos Anna Beatriz Salles, Goulart Amanda Evelyn Cruvinel

机构信息

State Department of Health of the Federal District, Brasília, FD, Brazil.

Faculty of Health Sciences, Brasília University Centre, Brasília, FD, Brazil.

出版信息

Rev Col Bras Cir. 2020;47:e20202406. doi: 10.1590/0100-6991e-20202406. Epub 2020 May 29.

Abstract

OBJECTIVE

to evaluate the clinical characteristics of patients with colorectal cancer under the age of 50 treated at a public hospital in Brasilia over 5 years.

METHODS

we conducted a longitudinal, retrospective study, with 184 patients undergoing surgical procedures at the Asa Norte Regional Hospital (HRAN), including those who underwent only biopsy, between January 2013 and January 2018. We divided the patients into two groups: under the age of 50 (n=39) and age equal to or greater than 50 years (n=145). We compared the groups as to age, sex, symptoms, time between symptom onset and diagnosis, family and personal history, tumor location, histopathological characteristics, applied surgical management, staging and mortality.

RESULTS

the group of patients under the age of 50 had more individuals with stage III and IV (p=0.041), more frequent poorly differentiated tumors (10.25% versus 3.52%; p=0.153), and higher incidences of compromised surgical margins (p=0.368), angiolymphatic (p=0.07) and perineural (p=0.007) invasion, which denotes more advanced disease in this group of patients.

CONCLUSIONS

the study showed the low effectiveness of population screening methods for colorectal cancer currently used in this population, given the high incidence of the disease and late diagnosis in both groups.

摘要

目的

评估在巴西利亚一家公立医院接受治疗的50岁以下结直肠癌患者的临床特征,研究为期5年。

方法

我们进行了一项纵向回顾性研究,研究对象为2013年1月至2018年1月期间在阿萨诺特地区医院(HRAN)接受手术治疗的184例患者,包括仅接受活检的患者。我们将患者分为两组:50岁以下(n = 39)和50岁及以上(n = 145)。我们比较了两组患者的年龄、性别、症状、症状出现至诊断的时间、家族和个人病史、肿瘤位置、组织病理学特征、应用的手术管理、分期和死亡率。

结果

50岁以下患者组中III期和IV期患者更多(p = 0.041),低分化肿瘤更常见(10.25% 对3.52%;p = 0.153),手术切缘受累(p = 0.368)、血管淋巴管(p = 0.07)和神经周围(p = 0.007)侵犯的发生率更高,这表明该组患者疾病更晚期。

结论

该研究表明,鉴于两组患者中该疾病的高发病率和晚期诊断情况,目前用于该人群的结直肠癌人群筛查方法效果不佳。

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