青年人结直肠癌71例临床分析

Clinical analysis of 71 young patients with colorectal carcinoma

目的结合文献探讨青年人(≤35岁)结直肠癌的临床特征,为青年人结直肠癌的早期诊治提供理论依据。方法回顾性分析1995年至2005年广西自治区肿瘤医院收治的71例青年人结直肠癌手术患者的临床特点、诊治情况及随访资料。结果本组71例患者均为手术患者,其中行根治性结直肠切除47例(66.2%),行姑息性手术24例(33.8%)。癌肿好发部位为直肠和乙状结肠,临床表现以便血或黏液血便、大便习惯改变、腹部疼痛不适多见。病理类型以管状腺癌、黏液腺癌多见,共55例,占77.5%。Dukes分期以C、D期多见,共46例,占64.8%。术后随访54例,总的3年生存率为59.3%(32/54)。结论青年人结直肠癌临床症状不典型,分化程度低,恶性程度高,进展快,易误诊、漏诊,手术根治率和生存率低,预后差。如何早发现、早诊断和早治疗(如提高对青年人结直肠癌的认识,预防致癌因素,高发地区及人员定期做好普查工作等)是提高手术根治率从而提高生存率的关键。

Objective To explore clinical characteristics of eolorectal carcinoma in young patients（≤35 years）. Methods Data of 71 young patients with colorectal carcinoma treated in the Affiliated Turnout Hospital of Guangxi Medical University from 1995 to 2005 was analyzed retrospectively. Results All the 71 cases were treated by operation. Radical resection were performed in 47 cases （66.20/00）, palliative resection in 24 cases （33.8%）. The rectum and the sigmoid colon were the common sites of colorectal carcinoma in young patients. Main clinical symptoms were changes in hematochezia or blood mucus stool, bowel movement habit and bellyache. The proportion of adenocarcinoma and mucinous carcinoma was 77.5%. The Dukes stages C and D in this group was found in 46 cases （64.8%）. 54 cases were followed up,and the 3 --year overall survival rate was 60%. Conclusion Colorectal carcinoma in young patients has the following features zatypical clinical symptoms, higher malignant degree, being misdiagnosed and missed diagnosed easily,lower rates of radical operation and survival. Early detection,diagnosis and treatment are the key of increasing rates of radical operation and survival.