青年人结直肠癌101例临床病理特征分析

Clinical pathological character analysis in 101 cases of young patients with colorectal cancer

目的探讨青年人结直肠癌临床特点与病理学特征。方法收集我院1996年1月—2007年12月间手术的101例青年结直肠癌患者的临床及病理资料,进行总结分析。结果101例青年结直肠癌患者中,误诊63例,误诊率达62.3%,误诊以肠炎、痔疮、痢疾多见;其发病部位以直肠最多,41例(40.6%);其次为乙状结肠,l8例(17.8%);降结肠最少,4例(3.9%);病理类型以管状腺癌、黏液腺癌多见,占73.3%;Dukes分期其中C+D期为主,56例,占55.4%。结论青年结直肠癌恶性程度高,误诊率高,预后差,早期行直肠指检对发现直肠癌有重要作用;电子结肠镜检查可及早诊断结直肠癌的癌前病变并适时进行干预,从而大大降低了结直肠癌的发生率,为治疗及预后评估提供重要依据。

Objective To study the clinical pathological character in 101 cases of young patients （ age 〈40 ） with colorectal cancer. Methods Applying statistic methods, we analyzed the clinical pathological feature of 101 cases of young patients with colon cancer who have been operated in hospital from January 1996 to December 2007. Results Sixty-three of 101 were misdiagnosed in this group. The misdiagnosis rate was 62. 3%. They were often misdiagnosed as bacillary dysentery, hemorrhoid and enteritis. In this group, rectal cancer was the most （40. 6% ） , followed by sigmoid colon cancer （17. 8% ） , descending colon cancer scarcely（3.9% ）. The proportion of adenocarcinoma and mucinous carcinoma was 73.3%. Dukes stages C and D was noted in 56 cases （55.4%）. Conclusion The young patiens with colorectal cancer have the characteristic of high misdiagnosis rate, high incidence of poor differentiation, more advanced stages and poor prognosis. It is important to digital rectal examine for colorectal cancer. Colonoscope examining can diagnose precancerous lesion early and interfere it in evolving at the right moment, so that can reduce the incidence of colorectal cancer. All can provide important evidence for treatment and prognosis appraisal.