不同区域大肠癌1040例临床特征比较分析

Comparative analysis of clinical features among 1040 patients with colorectal cancer in different districts of Chongqing

目的分析比较不同区域大肠癌患者临床特征的差异。方法收集该院2003-2012年首次经病理诊断证实的1 040例大肠癌患者的临床资料,从发病年龄、性别、结直肠比（CR=结肠癌频数/直肠癌频数）、病理类型、Dukes分期等方面比较主城区与非主城区大肠癌临床特征差异。结果主城区大肠癌患者平均年龄[（64.27±12.81）岁]高于非主城区[（58.66±13.39）岁],非主城区患者青年组所占比例高于主城区,而老年组所占比例低于主城区患者,差异均有统计学意义（P〈0.05）;主城区与非主城区患者均以男性多发,2003年与2012年相比,非主城区男女比例由4.00降至0.96,女性患者比例有增多的趋势,差异有统计学意义（P〈0.05）,主城区男女比例也由1.03降至0.86,但差异无统计学意义（P〉0.05）。主城区女性结肠癌更易分布在右半结肠,而男性结肠癌更易分布在左半结肠,差异有统计学意义（P〈0.05）。主城区大肠癌CR=0.64,非主城区CR=0.34,主城区结肠癌比例高于非主城区,差异有统计学意义（P〈0.05）,且不同年龄段CR值有显著差异。主城区与非主城区大肠癌均以腺癌为主,且非主城区青年组低级别腺癌比例高于中、老年组,差异均有统计学意义（P〈0.05）。非主城区肿瘤Dukes分期以Dukes B期为主（34.4%）,主城区以Dukes C期为主（33.7%）。结论该院2003~2012年收治的主城区与非主城区大肠癌患者在年龄、性别、结直肠癌发生部位等方面均存在差异,应重视不同地区大肠癌的筛查,及早发现早期病变。

Objective To comparatively analyze the main differences of clinical characteristics among the patients with colorectal cancer in different districts of Chongqing. Methods A total of 1 040 patients with colorectal cancer,who were confirmed by pathological diagnosis for the first time from 2003 to 2012 in our hospital, were collected. The differences of clinical features between main urban districts and non-main urban districts of Chongqing were compared from 5 aspects of the age onset,gender,colorectal ratio（CR）,pathological type and Dukes staging. Results The average age of the patients with colorectal cancer was（64.27±12.81） years old in the main urban districts and（58.66±13.39） years old in the non-main urban districts,showing the statistically significant difference（P0.05）. The proportion of the youth group in the non-main urban districts was higher than that in the main urban districts,while the proportion of the elderly group in the non-main urban districts was lower than that in the main urban districts,which both had statistical significant difference（P0.05）;the patients were mostly male patients in both main urban districts and non-main urban districts,while the male to female ratio of colorectal cancer patients in the non-main urban districts was fallen from 4.00 in 2003 to 0.96 in 2012,while the female patients showed the increasing trend,the differences were statistically significant（P0.05）,the male to female ratio in the main urban districts was fallen from 1.03 to 0.86,but the difference was not statistically significant（P0.05）. Colorectal cancer in the female patients was easily distributed in the right colon,and which in the male patients was easily distributed in the left colon,the difference was statistically significant（P0.05）. The CR value of colorectal cancer in the main urban districts was 0.64 and which in the non-main urban districts was 0.34,the proportion of colorectal cancer in the main urban districts was higher than that in the non-main urban districts,the difference was statistically significant（P0.05）,moreover the CR value in different age groups had statistically significant differences（P0.05）. The Dukes staging in main urban districts and the non-main urban districts showed that the non-main urban districts was dominated with the Dukes B（34.4%）,while the main urban districts was dominated with Dukes C（33.7%）. Conclusion The patients with colorectal patients in our hospital during 2003-2012 had differences in age,gender and location between the main urban districts and nonmain urban districts,the screening of colorectal cancer should be strengthened in order to early discover the lesion.