青海地区不同年龄段大肠癌患者临床特征分析

Clinical characteristics of colorectal cancer in different age groups in Qinghai Province

目的分析青海地区不同年龄段大肠癌患者的发病特点,为当地大肠癌防治策略提供依据。方法回顾性分析2006年1月-2015年12月青海省人民医院、青海大学附属医院、青海省红十字医院、青海省中医院、西宁市第一人民医院5家三甲医院收治的2 683例大肠癌患者的临床资料,将患者划分为青年组(<45岁)、中年组(45~59岁)和老年组(≥60岁)。以2年为一个时间段,统计各时间段3组的病例数。分析比较3组患者的性别、病变部位、病理类型、Dukes'分期、肿瘤直径等资料差异。结果三组患者性别比、肿瘤直径、肿瘤位置差异无统计学意义(P>0.05);但确诊时症状持续的时间,青、中年人群显著低于老年人群(P均<0.05);Dukes分期方面,青年组和老年组以C期最多,分别为52.3%和40.9%;中年组以B期最多,为33.6%;青年组处于C、D两期的病例数显著高于中、老年组(P均<0.05)。组织病理学方面,3组均以腺癌占比最高,分别为65.3%、70.4%以及72.1%;青年组的黏液腺癌、印戒细胞癌及未分化癌等高恶性程度癌占比为34.7%,高于中、老年组的29.6%及27.9%;其组织低分化占比为39.8%,显著高于中、老年组的21.1%及14.7%(P均<0.05)。结论 2006-2015年青海地区大肠癌发病率呈逐年增长趋势。青年患者的临床分期较中、老年患者晚,肿瘤的组织病理学恶性程度高。

Objective To analyze the characteristics of colorectal cancer in different age groups in Qinghai Province and provide evidences for the prevention and treatment of colorectal cancer. Methods Clinical data about 2 683 cases with colorectal cancer in 5 hospitals, including Qinghai People＇s Hospital, Qinghai University Affiliated Hospital, Qinghai Red Cross Hospital, Qinghai Hospital of T.C.M, Xining First People＇s Hospital, from January 2006 to December 2015 were retrospectively analyzed. Then the patients were divided into the young group（YG,45 years old）, the middle age group（MG, 45-59 years old） and the elderly group（EG≥60 years old）. The number of cases with colorectal cancer was counted in three groups every 2 years. The differences in patients＇ gender, lesion location, pathological type, Dukes＇ stage, tumor diameter and so on between three groups were compared. Results There was no significant difference in gender, tumor diameter and tumor location between three groups（P〉0.05）. Time from symptom onset to definitive diagnosis in YG and MG was significantly less than that in EG（all P〈0.05）. In Dukes＇ staging, stage C accounted for highest percentage in YG and EG with 52.3% and 40.9% respectively, while stage B accounted for highest percentage in MG（33.6%）. And the proportion of Dukes C and D in YG was significantly higher than that in MG and EG（all P〈0.05）. Histopathological examination results showed that adenocarcinoma accounted for the majority in three groups which were 65.3%, 70.4% and 72.1% respectively. The proportion of highly malignant cancer as mucinous adenocarcinoma, signet ring cell carcinoma and undifferentiated carcinoma in YG was 34.7%, higher than 29.6% and 27.9% in MG and EG; And the proportion of low differentiation in YG was 39.8% that was significantly higher than 21.1% and 14.7% in MG and EG（all P〈0.05）. Conclusion The incidence of colorectal cancer in Qinghai Province is increasing year by year from 2006 to 2015. The clinical stage of young patients is more advanced than that of middle and elderly patients, and the tumor is highly malignant in young patients.