536例左半和右半结肠癌患者的临床特征与预后的对照分析

Comparative Analysis of Clinicopathological and Survival Characteristics in 536 Patients with Right- or Left-Sided Colon Cancer

目的 研究分析左、右半结肠癌患者的临床病理特征与预后的对比情况.方法 回顾性分析苏州大学附属第一医院普外科2008年1月—2011年1月行手术治疗的536例结肠癌患者的临床病理特征,对比分析左、右半结肠癌患者的一般情况、临床表现、手术方式、病理特点等,统计随访（未失访）患者1年、3年、5年的生存率,采用Kaplan-Meier法绘制生存曲线,log-rank检验分析比较生存率的差异.结果 与左半结肠癌患者相比,右半结肠癌高龄女性患者居多,有贫血表现及癌胚抗原（CEA）升高者较多（P〈0.05）;且右半结肠癌中晚期、低分化（或未分化）、淋巴转移及肝转移患者比例较左半结肠癌高,差异均具有统计学意义（P〈0.05）.右半结肠癌1年生存率（98.2%）高于左半结肠癌（96.3%）（P〉0.05）,而3年生存率（81.0%）低于左半结肠癌（85.0%）（P〉0.05）;5年生存率右半结肠癌（62.9%）明显低于左半结肠癌（73.4%）（P〈0.05）.结论 左、右半结肠癌患者临床病理特征差异明显,且右半结肠癌患者5年生存率明显低于左半结肠癌.

Objective To clarify the clinicopathological characteristics and survival difference between right-and left-sided colon cancer. Methods We retrospectively analyzed the clinical characteristics （from 2008.1 to 2011.1） of 536 colon cancer patients who received surgery at our hospital. Right- and left-sided colon cancer were compared regarding the general situation, clinical manifestations, and pathological characteristics. Counted one-year, three-year and five-year survival rate of the patients who were followed up. The five-year survival curve was performed by the Kaplan-Meier method, and the log-rank test was used to compare the statistical significance of differences. Results Compared to the left-sided colon cancer, elderly women, clinical manifestation of anemia, high level of CEA, poorly differentiated and undifferentiated carcinoma, lymph node metastasis and liver metastasis were commonly seen in right-sided colon cancer, and all these differences were statistically significant （P〈0.05）. The one-year survival rate （98.2%） of right-sided colon cancer was higher than that of left-sided colon cancer （96.3%） （P〉0.05）, while the three-year survival rate （81.0%） was lower than that of left-sided colon cancer （85.0%） （P〉0.05）. The five-year survival rate of right-sided colon cancer （62.9%） was significantly lower than that of left-sided colon cancer （73.4%） （P〈0.05）. Conclusion Regarding the clinical characteristics, right-and left-sided colon cancer are significantly different. And the five-year survival rate of right-sided colon cancer is significantly lower than that of left-sided colon cancer.