不同年龄大肠癌的对比分析

Analysis on Carcinoma of Large Intestine at Different Age by Comparison

目的 比较不同年龄阶段大肠癌患者在临床表现和性别分布及肿瘤特征等方面的差别，以期探讨各年龄段之间的患病特点。方法 按年龄将２２１ 例大肠患者分为青年组（ ＜ ３５ 岁），中年组（３６ ～５９ 岁），老年组（ ＞ ６０岁） 。比较不同年龄段的性别、年龄、病程、首发症状、临床表现等一般资料和内镜下表现、肿瘤部位、病理、大体类型、分化程度、雌激素受体表达等肿瘤特征资料。结果 大肠癌以中老年人多见（９１．５％ ） ，青年组中患病男多于女（ Ｐ＜ ０．０１） 。青年人以腹痛为主（占７２ ．２ ％） ，多为剧痛。中老年人以血便／ 粘血便为主（ 占８２．５％ ），腹痛多为隐痛／ 胀痛。青年组右半结肠癌多于老年组。青年组多为Ｄ 期，中老年组多为Ｂ期和Ｃ 期。老年男性ＥＲ 阳性率显著降低。结论 大肠癌患病高峰为６０～７０ 岁。青年人右半结肠癌发生率高，恶性程度高，转移早，病程短，进展快，病期晚。中老年人左半结肠多见，病程长，分化好，检出晚。

Objective To study its disease feature at various ages,the clinical manifestation,sex distribution and carcinoma character were compared in cases suffering from carcinoma of large intestine.Method Both general information such as sex,age,course,initial symptom,clinical manifestation and information on tumor features such as endoscope trait,location,pathology,gross type,differentiation degree and estrogen receptor expression were recorded and compared.The groups wre classified as followe:adolescent group (≤35),adult group (36～59),old-aged group (≥60).Result Most carcinoma of large intestine occurred to the middle-aged patients (91.5%).The mumber of male patients were more than female in adolescent group ( P <0.01).Abdominal megalgia was a main complaint in youth (72.2%).Bloody stool or mucous bloody stool were mainly present in middle-aged group who often felt dull distending pain.The right colic carcinoma more appeared in youth than in the old group.The D stage was marked in youth while the B or C stage in the middle-aged group.The positive rate of ER decreased remarkably in aged group.Conclusion The case peak of carcinoma of large intestine was at the age of 60～70.The high prevalence rate,higher grade malignancy,early metastasis,rapid progression and late period were found in youth affected with right colica carcinoma,and long course,nice differentiation and late motice were found in the middle-aged patients affected with left colica carcinoma.