老年结直肠癌与中青年结直肠癌临床病理特征对比分析

Comparison of the clinicopathological characteristics of colorectal cancer between elderly and young patients

目的对比分析老年结直肠癌和中青年结直肠癌的临床病理特征,以提高对老年结直肠癌的认识及诊治水平。方法收集2003年1月至2005年12月广东省人民医院收治的727例结直肠癌患者,根据患者的年龄分为3组:老年组:≥60岁;中年组:36岁～59岁;青年组:≤35岁。回顾性分析老年结直肠癌患者其发病情况同中、青年结直肠癌患者的差异。结果各年龄组患者的发病部位均以直肠、乙状结肠、升结肠多发。老年组和中年组结直肠癌的首发症状主要表现为便血和排便习惯改变,青年组患者首发症状以腹痛、便血为主。老年组患者高分化腺癌、中分化腺癌的发生率明显高于中青年龄组患者。老年组和中年组患者行根治性手术的比例高于青年患者。老年组结直肠癌患者II,III期的比例明显高于中青年患者。老年患者确诊时合并心肺等疾病明显高于中、青年患者。结论老年结直肠癌患者确诊时并发症较多、根治手术率高,恶性度较低,临床应给予早期正确的诊断和积极的治疗。

Objective To compare the clinicopathological characteristics between elderly and young patients with colorectal cancer（CRC）.Methods A total of 727 patients with CRC treated between Jan 2003 and Dec 2005 were divided into elderly group（≥60 years old）,middle-aged group（36-59 years old）,and young group（≤35 years old）.The clinicopathological characteristics of the 3 groups were analyzed retrospectively.Results The tumoroccurred mainly in the rectum,sigmoid colon and ascending colon of the patients.The majorinitial symptoms included hemafecia and changes in bowel habits in the elderly and middle-aged cases,as compared to abdominal pain and hemafecia in the young group.The elderly patients had greater ratio of well differentiated neoplasm than the middle-aged and young patients.The ratio of radical operation was markedly higher in the elderly and middle-aged group than in the young group.The elderly patients were more likely to have stage II and III tumors than the middle-aged and young patients,having also significantly higher incidences of such complications as heart and lung diseases upon diagnosis.Conclusions Compared with the middle-aged and young patients,elderly patients with CRCare more likely to have well differentiated tumor,multiple complications upondiagnosis,andhigher radical operationrate.