按解剖部位分层的中国结直肠癌特征：一项于2014年至2018年在大学附属医院开展的基于医院的研究。
Features of colorectal cancer in China stratified by anatomic sites: A hospital-based study conducted in university-affiliated hospitals from 2014 to 2018.
作者信息
Qu Ruize, Ma Yanpeng, Tao Liyuan, Bao Xiaoyuan, Zhou Xin, Wang Bingyan, Li Fei, Lu Siyi, Tuo Lin, Zhan Siyan, Zhang Zhipeng, Fu Wei
机构信息
Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing 100191, China.
出版信息
Chin J Cancer Res. 2021 Aug 31;33(4):500-511. doi: 10.21147/j.issn.1000-9604.2021.04.07.
OBJECTIVE
The clinical and biological characteristics of colorectal cancer have been found to differ depending on the anatomic site of the cancer. However, for Chinese patients, there is limited information on the proportion of cases at each site and the related features. In this study, we explored the location, distribution and other features of colorectal cancers at each anatomic site in Chinese patients.
METHODS
We conducted a hospital-based study using hospitalization summary reports from 10 Peking University-affiliated hospitals from 2014 to 2018; the reports covered a total of 2,097,347 hospitalizations. Incident cases were chosen as the study population, and their epidemiological features were further analyzed.
RESULTS
A total of 20,739 colorectal cancer patients were identified. Rectum was the most common location (48.3%) of the cancer, whereas the proportions of patients with distal and proximal colon cancer were 24.5% and 18.6%, respectively. Patients with rectal cancer were predominantly male and were the youngest for all anatomical sites (each P<0.001). The highest proportion of emergency admissions, the longest hospital stays and the highest hospitalization costs were found in patients with proximal colon cancer (each P<0.001). The proximal colon cancer subgroup included the highest proportions of patients with medical histories of cholecystectomy, cholecystolithiasis and/or gallbladder polyps and appendectomy (P=0.009, P<0.001 and P<0.001, respectively). The distal colon cancer subgroup included the highest proportions of patients with medical histories of diabetes and hypertension (P<0.001, respectively).
CONCLUSIONS
The patterns of colorectal cancer observed in this study differ from those reported for Western patients and show a significantly higher proportion of patients with rectal cancer. Different epidemiological features were also found based on anatomic sites. Further studies based on tumor location should be conducted to facilitate more accurate screening and treatment.
目的
已发现结直肠癌的临床和生物学特征因癌症的解剖部位而异。然而，对于中国患者，各部位病例的比例及相关特征的信息有限。在本研究中，我们探讨了中国患者结直肠癌在各解剖部位的位置、分布及其他特征。
方法
我们利用2014年至2018年10家北京大学附属医院的住院总结报告进行了一项基于医院的研究；这些报告涵盖了总共2097347例住院病例。选取新发病例作为研究人群，并进一步分析其流行病学特征。
结果
共识别出20739例结直肠癌患者。直肠癌是最常见的发病部位（48.3%），而远端结肠癌和近端结肠癌患者的比例分别为24.5%和18.6%。直肠癌患者以男性为主，且在所有解剖部位中年龄最小（各P<0.001）。近端结肠癌患者的急诊入院比例最高、住院时间最长且住院费用最高（各P<0.001）。近端结肠癌亚组中胆囊切除术、胆囊结石和/或胆囊息肉病史以及阑尾切除术患者的比例最高（分别为P=0.009、P<0.001和P<0.001）。远端结肠癌亚组中糖尿病和高血压病史患者的比例最高（分别为P<0.001）。
结论
本研究中观察到的结直肠癌模式与西方患者报告的模式不同，直肠癌患者比例显著更高。基于解剖部位还发现了不同的流行病学特征。应开展基于肿瘤位置的进一步研究，以促进更准确的筛查和治疗。
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