不同发病部位结肠癌临床特征及预后分析

Variations in clinical characteristic and prognosis of colon carcinoma by location

  • 摘要: 目的 分析不同发病部位结肠癌的临床特征和预后。 方法 分析2007年1月-2010年6月在本院治疗的361例结肠癌患者资料,其中左半结肠癌194例,右半结肠癌167例。对患者发病年龄、性别、临床表现、组织学类型、有无脉管癌栓、淋巴结转移情况、远处转移、临床分期等进行分析。 结果 右半结肠癌患者与左半结肠癌相比,发病年龄较高(> 60岁,31.1%vs 18.0%),女性居多(61.1%vs 41.8%)。右半结肠癌的首发症状主要表现为腹部疼痛(37.3%)、便血(22.8%),部分可扪及腹部包块(23.4%);左半结肠癌表现为便血(54.1%)、肠梗阻(11.3%)。右半结肠癌与左半结肠癌低分化率(24.5%vs 12.9%)及脉管癌栓率(11.4%vs 6.7%)差异有统计学意义(P< 0.05)。右半结肠癌5年生存率69.5%,低于左半结肠癌的77.3%(P< 0.05)。 结论 左、右半结肠癌临床病理特征及预后不尽相同;右半结肠癌的发病年龄更大,女性发病率更高,低分化及脉管癌栓更多见,恶性程度更高,5年生存率更低。

     

    Abstract: Objective To analyze the clinical features and prognosis of colon carcinoma by location. Methods Clinical data, including age, gender, clinical symptom, histological features, vessel tumor emboli, lymph node metastasis, distant metastasis, clinical stage, about 361 cases with colon carcinoma who were treated in our hospital from January 2007 to June 2010 were analyzed, with 194 cases of left-colon carcinoma(LCC) and 167 cases of right-colon carcinoma(RCC). Results Patients with RCC showed older age and higher percentage of female patients than patients with LCC(> 60 years, 31.1% vs 18.0%; 61.1% vs 41.8%), and they mainly presented with abdominal pain(37.3%), hematochezia(22.8%), abdominal masses(23.4%), while rectal bleeding(54.1%) intestinal obstructions(11.3%) were more commonly seen in left-sided colon cancers.The histology results of patients with RCC showed higher percentage of poorly differentiated and vessel tumor emboli than patients with LCC with statistically significant difference(24.5% vs 12.9%; 11.4% vs 6.7%, P< 0.05).Moreover, the five-year survival rate of patients with RCC was significantly lower than patients with LCC(69.5% vs 77.3%, P< 0.05). Conclusion Right-and left-sided colon cancers are different from each other in terms of histology, clinical features and prognosis.Patients with right-sided colon cancer are older with higher percentage of female patients, poorly differentiated, vessel carcinoma embolus and degree of malignancy, and lower five-year survival rate.

     

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