青年期大肠癌临床病理特征及诊治分析

Clinicopathologic Features,Diagnosis and Treatment of Colorectal Carcinoma in Adolescence

目的探讨青年期大肠癌的临床特点,病理特征及预后影响因素。方法回顾性总结分析自1990年1月至2007年12月收治的85例青年期大肠癌的临床和病理资料。结果85例均行手术,其中根治性切除45例(52.9%)包括直肠癌30例,分别行Miles术式26例,Dixon术式4例;结肠癌15例,分别行右半结肠癌根治术8例,乙状结肠癌根治术7例。姑息性切除27例(31.8%)。因广泛腹腔转移仅行单纯造瘘或探查术13例(15.3%)。根治组5年生存13例(28.9%),姑息切除及探查造瘘术式均于手术后4个月至1年6个月死亡,平均生存期7个月。结论青年期大肠癌起病隐匿,症状出现迟,误诊率高,根治性手术切除率低,故预后差;早期诊断,早期治疗对改善预后至关重要。

Objective To explore the clinical and pathological feature of colorectal carcinoma in adolescence and factors influencing the prognosis. Methods Clinicopathologic feature of 85 patients with colorectal carcinoid in adolescence from Jan. 1990 to Dec. 2007 were analyzed retrospectively. Results Eighty-five patients were operated on, 45 patients including 30 rectal carcinoma underwent radical resection. Miles＇s operation was used in 26 cases and Dixon＇s operation was used in 4 cases. Fifteen patients underwent colorectal carcinoma resection; 8 underwent Right Hemicolectomy and 7 cases underwent Left Hmicolectomy;27 patients were by Palliative Resection and 13 patients were by colostomy. The follow-up of 70 patients found the five-year＇s survival rate of redieal resection was 28. 9% （13/70）, palliative resection and eolostomy of the average survival spans were 7 months. Conclusion The clinical symptoms of colorectal carcinoma in adolescence were non-specific,high misdignosis rates and low radical resection rates. Early diagnosis and timely operation are the key to improve the prognosis.