大肠癌153例临床、肠镜及病理分析

RETROSPECTIVE STUDY ON CLINICAL,ENDOSPIC AND PATHOLOGIC OF 153 PATIENTS WITH COLORECTAL CANCERS

目的探讨153例大肠癌的临床、肠镜及病理特点。方法回顾性总结我院2003年～2006年153例大肠癌患者，按年龄段分≤39岁组、40～59岁组及≥60岁组，分析其临床、肠镜及病理特点。结果153例大肠癌病例中40～59岁组人数最多，为67例，占43．79％。临床表现主要以便血为主。其次为腹痛、大便异常；≥60岁组以便血就诊的占75．00％，≤39岁组以腹痛就诊的占70．00％，说明临床症状具不典型性。大肠癌好发部位以直肠、左半结肠为主，各占44．44％及32．03％。病理结果分析，各组以高一中分化腺癌为主；≤39岁组低分化腺癌、印戒细胞癌及黏液细胞癌共占30．00％（9／30），明显高于≥60岁组和40～59岁组。结论大肠癌好发于中老年人，但青年人亦不容忽视，癌肿恶性程度高者占较高比例；大肠癌早期临床症状不典型，易误诊。在无症状老年人中开展筛检普查，对可疑病人进行肠镜检查，可大大提高大肠癌的早期诊断，改善大肠癌患者的预后。大肠癌好发于直肠，故部分病例可通过肛诊提供早期诊断依据。

Objeetiv To explore the characters of clinical, endospie and pathologic of 153 patients with eoloreetal cancer. Methods Picking out the patients with eoloreetal cancer from 1998 to 2006. According to age patients were divided into the under 39 age group, the 40 - 59 agegroup and the over 60 age group. Their dinieal expression endospie expression and pathologic data were analyzed retrospectively. Results The patients with eoloreetal cancer of the 40 - 59 age group ,were the largest numbers of the 67 patients, accounting for 43.79%. The bloody stools were mainly of clinical manifestations in all patients, followed by abdominal pain abnormal stool; The bloody stools were the main symptom in the over 60 age groups （ 75.00% ）, but the dominant abdominal pain was the main symptom in the under 39 age group （70. 00% ） , It is shown that the patients＇ clinical symptom are atypical. Coloreetal cancer located in reetmn and the left side of the colon were mainly,accounting for 44. 44% and 32.03%, Pathology results, Patients with high - differentiated adenocareinoma was the main pathological types ; The percentage in the under 39 age group with poorly differentiated adenocareinoma and signet - ring cell carcinoma and mucus adenocareinoma was higher than the over 60 age group and the 40 -59 age group（30. 00% vs 13.01% ,p 〈0. 05）. Conclusions The incidence peak of eoloreetal cancer oceured in the mid - age and aged, The high degree of malignant tumors accounted for a higher proportion in the young patients ; Early eoloreetal cancer clinical symptoms were not typical, easily misdiagnosed. It is screening among the midage and aged In asymptomatic and receiving endospic examination in suspicions patients can be greatly enhanced in the early diagnosis of coloreetal cancer, and can be improved the prognosis of the patients. Coloreetal cancer occurs in the rectum, there for some consultation through the examination in rectum can be supplied for early diagnosis.