Earls J P, Colon-Negron E, Dachman A H
Department of Radiology, Walter Reed Army Medical Center, Washington, DC 20307-5001.
Abdom Imaging. 1994 Sep-Oct;19(5):441-5. doi: 10.1007/BF00206935.
Colonic adenocarcinoma is an uncommon but aggressive neoplasm in patients under the age of 40. The goals of this study were to evaluate the utility of computed tomography (CT) in preoperative staging and detection of postoperative recurrences in young patients with colon cancer and to evaluate the pattern of recurrent disease. We reviewed 51 cases of adenocarcinoma in patients aged 40 years and younger. CT preoperatively staged 21 (72%) of 29 patients correctly and had a 100% positive predictive value for metastatic disease. Recurrent disease occurred in 23 (76%) of 30 nonstage D patients with at least 2 years of disease-free follow-up. CT accurately detected 21 (91%) of 23 cases of recurrent disease. Local recurrences were detected in 20 (87%) of 23 patients. Isolated local disease was the most frequent pattern of recurrence, seen in 17 (74%) of 23 patients. Hepatic metastases were rare and occurred in nine (13%) of 51 patients. Young patients with colon cancer have an increased prevalence of isolated local recurrences and decreased rate of hepatic metastases than the older population. In order to detect early, and therefore resectable recurrent disease, CT examinations should be obtained early and often in the postoperative period.
结肠腺癌在40岁以下患者中虽不常见但具有侵袭性。本研究的目的是评估计算机断层扫描（CT）在年轻结肠癌患者术前分期及术后复发检测中的作用，并评估复发疾病的模式。我们回顾了51例40岁及以下患者的腺癌病例。CT对29例患者中的21例（72%）进行了正确的术前分期，对转移性疾病的阳性预测值为100%。30例非D期患者中，有23例（76%）在至少2年的无病随访后出现复发。CT准确检测出23例复发疾病中的21例（91%）。23例患者中有20例（87%）检测到局部复发。孤立性局部病变是最常见的复发模式，23例患者中有17例（74%）出现。肝转移很少见，51例患者中有9例（13%）发生。与老年人群相比，年轻结肠癌患者孤立性局部复发的患病率增加，肝转移率降低。为了早期检测出可切除的复发疾病，术后应尽早且频繁地进行CT检查。
