594例原发性结直肠癌患者的临床流行病学研究

Clinical epidemiological features of 594 patients with primary colorectal cancer

目的探讨原发性结直肠癌的临床流行病学特点。方法收集近年收治的原发性结直肠癌住院治疗患者的临床资料,并按确诊时的年龄分组,分析临床表现、病理类型及大便潜血情况等特点。结果原发性结直肠癌患者的诊断年龄为非正态分布,中位诊断年龄为65岁;73.6%的结直肠癌位于左半结肠;腺癌占87.5%,其中中分化癌占66.35%;患者最常出现的症状是血便、腹痛、排便习惯改变,其次是体重下降、腹胀、腹泻、贫血、便秘、腹部包块;血便、腹痛、贫血、腹胀、腹部包块、体重下降、排便习惯改变等临床症状的出现与否均与肿瘤的发生部位密切相关(P均<0.05),右半结肠癌更常出现腹痛、贫血、腹胀、腹部包块和体重下降等症状,而左半结肠癌则更常出现血便和排便习惯改变。大便潜血与肿瘤的发生部位及Dukes分期没有明显的相关性(P>0.05)。结论结直肠癌患者的临床表现与肿瘤发生部位密切相关,血便、腹痛、排便习惯改变等是最常见的临床表现;腺癌是最常见的临床病理类型。

Objective To detect clinical epidemiological features of primary eolorectal cancer （CRC） patients. Methods Five hundred and ninety-four hospitalized patients with primary CRC were collected. Clinical data about all patients were collected. According to diagnosed cancer age of patients, all patients were grouped. Clinical characteristics, pathological type and fecal occult blood of patients were analyzed. Results Diagnosed age of primary CRC patients was not normal distribution. The median diagnosed cancer age was 65 years. 73.6% patients were in left-side colorectal cancer. In pathological type, adenocarcinoma accounted for 87.5%. Among them, moderate cell differentiation was differentiated in 66.35% patients. Most common clinical features were bloody stools, abdominal pain and change of bowel evacuation habit, next to body weight loss,abdominal distention, diarrhea, anemia, constipation, abdominal mass. Among them, most clinical features were correlated with cancer onset site （P 〈 0.05）. Cancer in right-side colorectum than left-colorectum had more frequently abdominal pain, anemia, abdominal distention, abdominal mass and body weight loss. Otherwise, left-side colorectal cancer occurred more frequently blood stools and the change of bowel evacuation habit. There was no significant correlation between fecal occult blood, cancer onset site and Dukes staging of colorectal cancer （P 〈 0. 05）. Conclusion Clinical features of primary CRC patients were correlated with cancer onset sites. Blood stools, abdominal pain and change of bowel evacuation habit were the most common clinical characteristics. Adenocarcinoma was the most common pathological type of primary CRC.