Stubbs R S, Long M G
Eur J Surg Oncol. 1986 Jun;12(2):127-30.
A large proportion of patients with colorectal cancer continue to present with relatively advanced and therefore incurable tumours. While delay in diagnosis is often felt to have been a contributing factor, the validity of this has seldom been questioned. Two hundred and eleven consecutive large bowel cancer patients have been prospectively studied with respect to their duration of symptoms and pathologic stage: 7.1% presented with Dukes A tumours and a mean symptom duration of 11.2 months; 38.9% with Dukes B tumours and a mean symptom duration of 4.9 months; 22.3% with Dukes C1 tumours and a mean symptom duration of 5.3 months; 3.8% with Dukes C2 tumours and a mean symptom duration of 3.9 months and 26% with stage D disease and a mean symptom duration of 3.8 months. There was no tendency for a longer symptomatic period in patients with more advanced disease. Indeed the Dukes A patients had a significantly longer duration of symptoms than those with all other stages of disease. It is argued that diagnosis at a more favourable pathologic stage would only be possible by presymptomatic tumour detection.
很大一部分结直肠癌患者就诊时仍表现为相对晚期因而无法治愈的肿瘤。虽然人们常常认为诊断延迟是一个促成因素，但这一点的正确性很少受到质疑。我们前瞻性地研究了211例连续性大肠癌患者的症状持续时间和病理分期：7.1%的患者为Dukes A期肿瘤，平均症状持续时间为11.2个月；38.9%为Dukes B期肿瘤，平均症状持续时间为4.9个月；22.3%为Dukes C1期肿瘤，平均症状持续时间为5.3个月；3.8%为Dukes C2期肿瘤，平均症状持续时间为3.9个月；26%为D期疾病，平均症状持续时间为3.8个月。病情越晚期的患者并没有出现症状期更长的趋势。事实上，Dukes A期患者的症状持续时间明显长于其他所有疾病分期的患者。有人认为，只有通过症状前肿瘤检测才有可能在更有利的病理分期进行诊断。
