大肠黏液腺癌临床病理特征的分析

Pathological features of colorectal mucinous adenocarcinoma

目的深入分析大肠黏液腺癌独特的临床病理特征以指导临床诊断治疗,提高患者的预后。方法回顾性分析117例大肠黏液腺癌和424例大肠非黏液腺癌的临床和病理资料,并对各种临床和病理资料进行统计学分析。结果 (1)与非黏液腺癌相比,大肠黏液腺癌好发的年龄段偏低(平均年龄<50岁);(2)黏液腺癌好发于右半结肠,尤其是升结肠,但非黏液腺癌好发于左半结肠和直肠,且更多发于乙状结肠;(3)黏液腺癌瘤体相对较大(直径>5cm),分化程度更差;(4)黏液腺癌的分期相对较晚,更易向周围浸润生长,更易发生淋巴转移和远处转移;(5)蛋白nm23、p53在黏液腺癌中的阳性表达率更低。结论大肠黏液腺癌是一类预后较差的大肠癌,对大肠黏液腺癌应该采用更加积极全面的治疗方式。

Objective To improve the prognosis of colorectal mucinous adenocarcinoma （MC） by analyzing clinicopathologic features of the tumor. Methods Clinicopathologic features of 541 patients with colorectal cancer （117 MC vs. 424 non-MC patients） were reviewed retrospectively. Results Compared with non-MC, MC had a predilection for younger people （mean age 50 years）. The most common site of MC was at the right hemicolon, especially at the ascending colon, while the most common site of non-MC was at the left hemicolon and rectum,especially at the sigmoid colon. The tumor size of MC was usually larger than that of non-MC. The staging of MC was relatively late, and MC was prone to have local infiltration and lymph node involvement and metastasis The expression rate of nm23 and P53 in MC was lower than that in non-MC. Conclusion Since the prognosis of colorectal MC is poor,aggressive and comprehensive treatment including surgical intervention should be recommended to improve clinical outcome.