儿童大肠癌临床病理分析

Analysis of Clinical Pathological Characteristics of Large Bowel Carcinoma in Children

目的：报告和分析儿童大肠癌的临床、病理及预后特点。方法：收集本院1980年至1995年收治的儿童大肠癌．进行回顾性分析。结果；15年间共收治5例，均为男性，占同期收治大肠癌的0．041％。肿瘤主要位于右半结肠．临床表现以中上腹疼痛、不适及消瘦、贫血为主．3例急腹症入院。病理类型以粘液腺癌后多（4例）。手术治疗为主。2年生存率40％，无5年生存者。结论：儿童大肠癌发病率低，以男性患儿多见；早期症状不典型，以中上腹反复疼痛及消瘦贫血为主要症状；主要发生于右半结肠；直肠癌者可有早期的大便习惯改变及粘液血便史；误诊率高，常以急腹症入院；病理分期较晚，就诊时以Dukes’C或D期多见；病理类型以高度恶性的粘液腺癌为主；预后差。

Purpose: To analyse the clinical pathological characteristics of large bowel carcinoma in children. Methods: An analysis of large bowel carcinoma in children from 1980 to 1995 was carried out retrospectively. Results, 5 cases of the patients were admitted in 1980-1995 accounting for 0.041 % of the total cases with colorectal carcinoma in the same peried, and all the cases were males. The main sites of tumor were found in the right semicolon. The common symptoms were mid-and upper-abdominal pain, decrease in body weight and anemia, three cases admitted as acute abdomens. The predominant pethological pattern was mucinoadenocarcinoma (4cases). All cases have been treated by operation. The 2-year survival rate was 40%. Conclusions: There are some characteristics of large bowel carcinoma in chidren as following:①low incidence of occurancel; ②intypical early symptoms, the common symptoms including mid-or upper-abdominal pain, decrease in body weight and anemia; ③predispossing sites of onset in right semicolon; ④simillar manifestions with adult, such as early habitual change in bowel movement, and bloody stool;⑤high missing rate in diagnosis: ⑥common in advanced stages (Dukes' C or D) when diagnosis; ⑦with a predominant pathological pattern of mucinoadenocarcinoma with high nalignancy; ⑧poor prognosis.