低龄结肠癌患者临床特点及预后分析

Clinicopathological characteristics and prognosis of younger colon cancer patients

目的:探讨低龄结肠癌患者的临床病理特征及预后状况。方法:回顾我院2001年9月-2010年9月间收治的62例低龄及325例中高龄结肠癌患者的临床病理及术后随访资料。SPSS统计软件包对所有数据进行统计分析。生命表法计算生存率,绘制生存曲线,Long rank检验比较生存率曲线。结果:本组低龄结肠癌病例占同期结肠癌患者的16%。两组结肠癌患者在性别及肿瘤发生部位的差异均没有统计学意义(P>0.05)。低龄结肠癌病理类型以低分化、未分化、黏液腺癌和印戒细胞癌多见,共39例,占62.9%(39/62),中高龄组占8.3%(27/325),(P<0.05);高、中分化腺癌则相反,中高龄组占91.7%(298/325),低龄组占37.1%(23/62),(P<0.05)。低龄组Dukes分期多以C、D期为主,中高龄组以A、B期为主,分别占71.0%和85.7%;低龄结肠癌患者临床分期多以Ⅲ、Ⅳ期为主(76.4%),中高龄组Ⅱ期为主(61.8%)。术后3、5年生存率中高龄组明显优于低龄组,分别为80.0%、54.4%和48.6%、10.0%,(P<0.05)。结论:与中高龄结肠癌相比,低龄结肠癌在确诊时,分期较晚、组织学分化程度低、病理特征恶性程度高、预后差、生存率低。早期发现、早期诊断和早期治疗是提高低龄结肠癌患者生存率的关键。

Objective：To investigate the clinicopathological characteristics and postoperative status of younger co- lon cancer patients. Methods： Clinic pathological characteristic and follow -up data of 62 young adult （ ≤〈40 years） and middle - old adult （ 〉 40 years） of 325 colon cancer patients in our hospital during September 2001 to September 2010 were retrospective analyzed. The differences of clinicopathological characteristics and survival rate between the two groups were analyzed with the life table method and Long rank. Results： Younger patients with colon cancer cases accounted for 16% over the same period. Two groups of patients with colon cancer were not statistically significant differences in the gender and tumor location （P 〉 0.05）. In pathology, the younger age group was mainly in poorly differentiated, undifferentiated, mucinous adenocarcinoma and signet ring cell carcinoma, a total of 39 cases, ac- counting for 62.9% （39/62）, highly differentiated adenocarcinoma, 23 cases of colon cancer patients, accounting for 37.1% （23/62）. In contrast, in the middle age and elderly group, accounting for 8.3% （27/325） and 91.7% （298/325）, （P 〈 0.05）. Dukes staging of colon cancer patients in the younger group was mainly in C, D period, while the middle age and elderly group to A, B phase dominated, accounting for 71.0% and 85.7%. In clinical staging in colon cancer, the younger age group of patients with colon cancer was mainly in stage Ⅲ, Ⅳ while the middle age and elderly was more common in stageⅡ , respectively, 76.4% and 61.8%. The 3, 5 -year survival rate after surgery of the middle age and elderly group was significantly higher than in the younger age group, 80.0%, 54.4% and 48.6%, 10.0% respectively, the difference was significant statistically significant （P 〈 0.05）. Conclu- sion：Compared with the middle age and elderly patients, the younger colon cancer patients were characterized at di- agnosis by advanced stage, poor differentiation, high malignancy, poor outcome, low survival rate.