青年人枞误诊及病例分析

Analysis of misdiagnosis on rectal cancer of youth

目的探讨青年人直肠癌的临床病理特点及误诊原因。方法回顾性分析66例青年人直肠癌误诊病例（年龄≤35岁）的临床资料。结果66例患者中行直肠癌根治术41例，占62．1％，姑息切除术25例，占37．9％，患者术后均给予常规化疗。术后随访57例，随访率为86．4％。根治术后3、5年生存率分别为42．4％、30．3％；术后局部复发率为37．8％，且多发生在2年内。姑息切除术后生存2—15个月。结论青年人直肠癌误诊率高，临床表现以黏液血便和便频为主，进展快，恶性程度高，转移早，根治率低，预后差。早发现、早诊断、旱治疗是提高青年人直肠癌患者生存率和生活质量的关键。

Objective To explore the clinic pathological characteristics and reasons of misdiagnosis on rectal cancer among the youth（ ≤ 35 years of age）. Method The clinic pathological data of the 66 ntisdiagnosed young patients with rectal cancer from January 1993 to December 2001 were retrospectively analysed. Results Radical surgery was 62.1%, palliation resection operation was 37.9%. Three and 5-year survival rates after surgery, were 42.4%and 30.3% respectively. Region recurrence rate was 37.8%. Conclusions The first clinic manifestation of young patients with rectal cancer is mucus blood stool and frequent stool, it has relatively early metastasis, fast progress, high malignancy and misdiagnosis, low radical rate and bad prognosis. Early discovery, diagnosis and treatment are necessary to elevate survival rates and quality of life for young patients.