宜昌市20年结肠镜检查大肠癌患病率回顾性分析

Retrospective study of morbidity rate of colorectal cancer underwent colonoscopy cases of Yichang city of past 20 years

目的探讨该市大肠癌流行病学和临床特点。方法以所有结肠镜受检对象为研究群体,对大肠癌患病率、大肠癌患者性别、年龄、肿瘤部位进行统计分析;比较大肠癌临床症状与大肠癌患者年龄、肿瘤发生部位的关系。结果自1980年以来,大肠癌年度患病率呈非线性缓慢上升,男性大肠癌患病率7.1%;女性大肠癌患病率5.5%;在3个年限段(80年代、90年代和21世纪5年)大肠癌中位患病年龄分别为男53.5、56.7和59.0岁;女51.9、53.7和55.2岁。986例大肠癌中直肠癌691例,乙状结肠癌82例,降结肠癌18例,脾曲癌4例,横结肠癌37例,肝曲癌30例,升结肠、回盲部癌79例,大肠多发性癌45例。临床症状以便血为主,其次为腹痛、腹部包块和肠梗阻发生率较低,半数以上患者有不同程度贫血。结论该市大肠癌患病率和中位发病年龄呈缓慢上升,低于国内大肠癌高发区。大肠癌肿瘤发生部位有近移和多发趋势。便血是直肠癌主要症状,中老年患者便血发生率高于青年患者,但腹痛发生率低于青年患者。

[Objective] To investigate the epidemiological and clinical features about colorectal cancer of Yichang city. [Methods] All colonoscopy cases were observed. The statistical analysis of the annual sickness rate, sex, age, cancer site of the colorectal carcinoma was performed. And the colorectal cancer case age, sites was compared. [Result] From1980s, the annual case rate of colorectal cancer appeared slowly non-lineal increasity, male rate was 7.1%, female was 5.5%; male median sickness age of colorectal cancer was 53.5, 56.7, 59.0 years old respectively and female was 51.9, 53.7, 55.2 years old in the 80 s, 90 s and the 21st century （2000-2004）. There were 691 cases of rectal carcinoma, 82 cases of sigmoide cancer. Descending colon cancer was 18 cases, splenic flexture of colon 4 cases, transverse colon cancer 37 cases, liver-flexture of colon 30 cases, the ascending colon and ileocecal cancer 79 cases and the multiple large intestine cancer 45 caces. Main clinical syndrome of colorectal cancer was hematochezia and the secandamy was abdominal pain, the appearance of abdominal mass and intestinal obstruction was seldom. There were at least haft cases suffered from anemia. [Conclusion] In the city, the morbidity rate and median sickness age of colorectal cancer were slowly increasing, but were lower than others sickness peak area. The cancer site had multiple and near metastasis feature. Hematochezia was the main syndrome of rectal cancer and it happened commonly in old age than younger cases, but the abdominal pain was lowered happenes then younger.