257例大肠癌患者的临床特征、病理及预后分析

摘要

目的：分析大肠癌患者的临床特征、病理及预后。方法收集苏州大学附属第一医院2013年1月—2015年3月临床确诊的257例大肠癌临床病例，并对其临床特点、病理特征及预后情况进行回顾性分析。结果该组257例大肠癌患者中年龄≤40岁10例，40～60岁106例，＞60岁141例；结肠癌146例，男80例，女66例，男女比例1.21：1；直肠癌111例，男73例，女38例，男女比例1.92：1；大肠癌（结、直）中男女比例1.47：1；该组病例病变部位以直肠（43.19%）、乙状结肠（19.84%）和升结肠（19.46%）多见；病理类型发现高分化腺癌1例，中分化腺癌207例，中低分化腺癌32例，黏液腺癌15例，管状腺癌1例，其他少见癌1例；预后情况分析发现257例大肠癌患者中，无瘤存活者192例（占随访成功例数239例的80.33%），复发转移者29例，死亡者18例，大肠癌1～2年生存率约为80.33%，复发转移及死亡与淋巴结转移度相关。结论大肠癌好发于中老年患者，部位以直肠及乙状结肠、升结肠多见，病理类型中以中分化腺癌多见，1～2年生存率可。通过对大肠癌的临床特点、病理特征及预后情况的研究，可以发现大肠癌的发病率高，恶性程度高，病情程度严重，故应强化大肠癌临床病理分析，重视早期诊断与治疗。%Objective To analyze the clinical characteristics, pathology and prognosis of patients with colorectal cancer.Methods The clinical data of 257 patients with colorectal cancer admitted from January 2013 to May 2015 in the First Affiliated Hospital of Soochow University were retrospectively analyzed, and their clinical characteristics, pathology and prognosis were reviewed.ResultsAge: Among 257 patients with colorectal cancer, there were 10 patients with under 40, 106 patients between the ages of 40 and 60, and 141 patients over 60. Colorectal cancer most often occurs in years that were older than 40. 146 patients with colon cancer consist of 88 males and 66 females (1.21:1) and 111 patients with rectal cancer include 73 males and 38 females (1.92:1). The above data show that there is no signiifcant difference between the incidence of males and females with colon cancer, while the incidence of rectal cancer in male is higher than that in female, close to 2 times. The lesion location: The most frequent lesion was the rectum (43.19%), sigmoid colon (19.84%) and the ascending colon (19.46%). Pathological types: Among 257 cases, 1 case was highly differentiated adenocarcinoma, 207 cases were moderately differentiated adenocarcinoma, 32 cases were moderately and poor-differentiated adenocarcinoma,15 cases were mucinous adenocarcinoma,1 case with tubular adenocarcinoma and 1 case with other rare cancer. So most of colorectal cancers were moderately differentiated adenocarcinoma. Prognosis: until February in 2016, among 257 cases,192 patients survive free of the tumor (accounting for 80.3% of the follow-up), 29 patients with recurrence and metastasis, 18 patients died of colorectal cancer. The 1 to 2 years survival rates of colorectal cancer was about 80.3%, recurrence, metastasis and death is closely related to lymph node metastasis.Conclusion The tumor most often occur in middle-aged and old patients. The most frequent lesion of the tumor was the rectum, sigmoid colon and the ascending colon. Moreover, most of the colorectal were moderately differentiated adenocarcinoma and the 1 to 2 years survival rates of colorectal cancer is relatively high. We can ifnd colorectal cancer with high incidence, a high degree of malignancy and serious condition through the study of clinical characteristics, pathology and prognosis. So the clinical pathological analysis of colorectal cancer should be strengthened and importance should be attached to early diagnosis and treatment.