青年与中老年结直肠癌患者的临床特征对比分析

Comparative analysis on the clinical pictures of colorectal carcinoma in youths and in the middle-old ages

目的：对比分析青年及中老年结直肠癌患者的基本特征与病理特征。方法：回顾性分析皖南医学院弋矶山医院2012年1月～2015年8月所收治的1247例青年及中老年结直肠癌患者,其中年龄≤40岁的62例,剔除1例患者资料不完整者,另外随机选取713例年龄〉40岁的结直肠癌患者做对比,并在基本特征与病理特征方面做对比研究。结果：两组在肿瘤发生部位上差异有统计学意义（P〈0.05）,在性别、病程时间、住院时间、肿瘤最大直径、首发症状、手术时间、术中出血量、手术方式方面差异无统计学意义（P〉0.05）。在原发肿瘤浸润深度（T）和淋巴结转移情况（N）上差异有统计学意义（P〈0.05）,而在远处转移（M）中差异无统计学意义（P〉0.05）。在临床分期、组织学类型、分化程度方面两组差异有统计学意义（P〈0.05）。结论：青年结直肠癌临床症状较隐匿,具有分化程度低、早期转移率高、组织学类型差等病理学特点,强调对青年患者初次就诊的正确率,制定多学科综合治疗模式。

Objective：To compare and analyze the clinical pictures and pathological properties of colorectal cancer in young adults and middle aged and elderly patients.Methods：Retrospective analysis was performed in 1247 colorectal cancer cases of youth and of middle aged and elderly admitted to our hospital between January 2012 and August 2015.of the 1247 patients,62 were aged 40 years or younger, and one case was excluded due to incomplete data access.Another 713 colorectal cancer cases aged over 40 years were randomly included as controls for comparison of the clinical pictures and pathological characteristics.Results ：The two groups were significantly different regarding the tumor location （P〈0.05） ,yet were not pertaining to the gender, disease course, length of hospital stay, maximal diameter of tumor, initial symptom, operative time, intraoperative blood loss and surgical mode （ P〉0.05 ） .There was significant difference in the primary tumor invasion depth （N） and lymph node metastasis （T） （P〈0.05）, whereas the difference was not significant con- cerning distant metastasis （M） （P〉0.05）.However,the difference was significant between the two groups regarding the clinical stage ,histological type and differentiation degree （P〈0.05）.Conclusion ：The clinical symptoms of colorectal cancer appear obscure for young patients, and are characterized by low de- gree of differentiation, high rate of early metastasis and poor histological type.Therefore, accurate early diagnosis and treatment on multidisciplinary options basis are critical for this group of population.