结直肠黏液腺癌与印戒细胞癌的临床病理特征与预后生存分析

Clinicopathological features of colorectal mucinous carcinoma and signet-ring cell carcinoma and prognostic analysis

目的分析结直肠黏液腺癌与印戒细胞癌的临床病理特征与患者预后生存情况,为临床治疗提供参考。方法选取2008年5月至2015年5月住院治疗的原发性结直肠癌患者1 466例,其中黏液腺癌152例,印戒细胞癌76例。对所有患者的临床资料进行回顾性分析,并分析比较黏液腺癌和印戒细胞癌患者的临床病理特征、病理报告结果和生存情况。结果印戒细胞癌与黏液腺癌在发病年龄、肿瘤部位、有无肠梗阻、手术方式、脉管瘤栓、浸润深度、淋巴结转移方面差异均具有统计学意义(P均<0.05);在性别、术前CEA水平和肝转移方面差异无统计学意义(P均>0.05)。76例印戒细胞癌中位生存期26个月,152例黏液腺癌中位生存期47个月,差异具有统计学意义(P<0.05)。黏液腺癌患者1、3年生存率高于印戒细胞癌患者(P<0.05)。结论结直肠印戒细胞癌恶性程度高于黏液腺癌,其预后差的原因可能与其发生部位和独特的病理类型有关。

Objective To compare the clinicopathological features and prognosis of colorectal mucinous carcinoma and signet-ring cell carcinoma. Methods Out of 1 466 admitted primary colorectal cancer patients between May 2008 and May 2015,152 patients with mucinous adenocarcinoma and 76 patients with signet-ring cell carcinoma were selected. Retrospective analysis was performed on patients＇ clinical data,and the clinicopathological features and survival situation were compared. Results There were significant differences in age of onset, tumor sites ,with or without intestinal obstruction, operative method, vessel carcinoma embolus（ all P 〈 0.05 ） and no significant differences in sex, preoperative cancer embryonic antigen （CEA） level and with or without hepatic metastasis （ all P 〉 0.05 ）. There was significant difference in median survival times between patients with signet-ring cell carcinoma and mueinous adenocarcinoma （26 months vs 47 months,P 〈 0. 05 ）. The 3-year survival rate in patients with mucinous adenoeareinoma was significantly higher than that in patients with signet-ring cell carcinoma （ P 〈 0.05 ）. Conclusion The malignant degree of coloreetal signet-ring cell carcinoma is high- er than that of mueinous adenoearcinoma, and the reasons of the poor prognosis of signet-ring cell carcinoma may be associated with its sites and special pathologic type.