结直肠癌解剖部位与临床病理学关系的研究

A study on the relationship between anatomic site distribution and clinical pathology of colorectal cancer

目的探讨结直肠癌解剖部位与临床病理学特点间的关系。方法对 1 990～ 1 999年间收治的有完整临床资料的 790例结直肠癌进行回顾性分析。结果黏液腺癌在近、远端结肠癌、直肠癌中分别占 2 6 5 % (5 4 /2 0 4 )、1 0 1 % (1 5 /1 4 8)、9 4 % (36 /385 ) ;低分化癌在三个部位肿瘤中分别占 1 4 5 % (2 3/1 5 9)、5 7% (7/1 2 2 )、1 0 0 % (33/330 ) ;进展期癌 (DukesB期及B期以上 )分别占85 3% (1 6 8/1 97)、75 3% (1 1 3/1 5 0 )、77 1 % (2 96 /384 )。近端结肠癌同远端结肠癌或直肠癌相比差异均有显著性意义 (P <0 0 5 ) ;远端结肠癌同直肠癌相比 ,两者在分化程度上差异有显著性意义 (P <0 0 5 ) ,但在病理类型构成、肿瘤分期上无明显差异 (P >0 0 5 )。结论近端结肠癌具有明显不同于远端结肠癌或直肠癌的临床病理学特征 ,黏液腺癌更常见、分化更差、分期更晚 。

Objective To study the relationship between anatomic site distribution and clinical pathologic characteristics of colorectal cancer(CRC). Methods Clinical data were collected from 790 patients in Nanfang Hospital admitted from 1990 to 1999. Results Mucous adenocarcinoma accounted for 26 5% in proximal colon, 10 1% in distal colon and 9 4% in rectum; Poor differentiation cancer accounted for 14 5%,5 7% and 10 0% respectively, and 85 3%,75 3% and 77 1% was in advanced stage of cancer (Dukes B, C and D) in proximal, distal colon and rectum respectively. There was significant difference( P <0 05) between the characteristics of proximal colon cancer and that of distal colon or rectal cancer. Distal colon cancer was different from rectal cancer, in differentiation ( P <0 05), but the difference was not significant ( P >0 05) in pathologic type and tumor′s stage. Conclusions Proximal colon cancer has some significantly different characteristics from distal colon or rectal cancer, with more mucous adenocarcinoma, poor differentiation and later tumor stage.