摘要
目的:探讨青年直肠癌患者临床、病理特点及预后相关因素,以提高其诊断水平和治疗效果。方法:回顾性对比分析47例青年直肠癌(≤40岁)与99例老年直肠癌(≥65岁)患者在临床、病理特征及预后等方面的差异,进而总结青年直肠癌的特点。结果:青年组平均病程为6.98个月,短于老年组(9.16个月)。青年组直肠癌的误诊率达61.70%,明显高于老年组(28.28%)(P<0.05)。青、老年两组肿瘤距肛缘的平均距离分别为6.94和7.01 cm,两组比较差异无显著性。青年组分化差的癌占52.18%,发生淋巴结转移的占52.17%,高于老年组(30.52%和23.16%)(P<0.05)。青年组术前并发症和术后并发症的发生率分别为31.92%和34.04%,显著低于老年组(81.82%和55.56%)(P<0.05)。青、老年两组直肠癌的累计5年生存率分别为45.7%和56.2%,两组比较差异无显著性。结论:青年直肠癌病程短、误诊率高、分化差、易发生淋巴结转移、病理分期晚,但两组的累计5年生存率有相接近的趋势;肿瘤浸润深度和淋巴结转移是影响预后的重要因素,加强早期诊断和科学、规范的治疗有望进一步改善青年直肠癌的预后。
Objective To investigate the clinical characteristics of young rectal carcinomain in order to improve the diagnostic level and therapeutic efficacy at the early stage.Methods Clinical data,including clinical manifestations,misdiagnosis,clinical pathology and prognosis which from 47 cases of young rectal carcinoma were analyzed retrospectively and compared with those from 99 cases of old rectal carcinoma.Results The average course of disease was 6.98 months in young patient group,it was shorter than that in old patient group（9.16 months）.The misdiagnosis rate of young group（61.70%） was significantly higher than that in old group（28.28%）（P〈0.05）.The average distance between tumor and the anal verge was 6.94 cm in young group and 7.01 cm in old group,there was no difference between them.The occurrence of mucouis adenocarcinoma,low differentiated adenocarcinoma,and signet cell carcinoma in young group（52.18%） was higher than that in old group（30.52%）（P〈0.05）.Lymph node metastasis wasfound in 52.17% of young patients,which was much higher than old group（23.16%）（P〈0.05）.Both preoperative and postoperative complications in young group were less than those in old group（P〈0.05）.The overall 5-year survival rates in young and old groups were similar（45.7% and 56.2%）（P〉 0.05）.Conclusion Compared with the old patients,advanced stage and poorly differentiated carcinoma are more common in young patients with rectal carcinoma.But the 5-year survival rates of the young and old patients are similar.In addition,T stage and lymph node metastasis are the independent prognostic factors.Therefore,early diagnosis and treatment are crucial to improve the survival rate in young patients with rectal carcinoma.
出处
《吉林大学学报（医学版）》
CAS
CSCD
北大核心
2009年第4期726-730,共5页
Journal of Jilin University：Medicine Edition
基金
吉林省科技厅科研基金资助课题(20080904)
关键词
直肠肿瘤
临床特征
预后
rectal neoplasms
clinical characteristics
prognosis
作者简介
崔晓峰（1981-），男，吉林省延吉市人，医师，医学硕士，主要从事结直肠肿瘤的诊断、治疗以及基础研究。
[通讯作者]张海山（Tel：0431—84995265，E-mail：zhanghaishanmd@yahoo．com.cn）
