Ⅰ期结直肠癌局部复发与转移18例患者的临床病理特征分析

Analysis of 18 cases of Stage Ⅰ colorectal cancer:before and after local relapse and distant metastasis

目的探讨早期结直肠癌复发与转移的高危因素、诊断与治疗现状,以期改善预后。方法回顾性总结2005年3月至2008年5月中国医学科学院肿瘤医院收治的18例Ⅰ期、无脉管瘤栓与神经侵犯但出现复发及转移的结直肠癌患者临床病理资料。结果 18例Ⅰ期局部复发与远处转移的结直肠癌患者中,男性12例(66.7%),女性6例(33.3%),术前便血15例(83.3%),无体重减轻11例(64.7%),T1肿瘤2例(11.1%),T2肿瘤16例(88.9%),局部复发7例(38.9%),远处转移9例(50.0%),淋巴结转移2例(11.1%)。11例患者(61.11%)的复发与转移没有临床症状。复发转移后中位生存期为57.6个月。结论Ⅰ期结直肠癌患者必须常规进行定期复查,要重视复发与转移的早期症状。

Objective To discuss the high-risk factor, diagnosis and treatment of the relapse of stageI (T1-T2) colorectal cancer. Methods We retrospectively analyzed the clinical and pathological factors of18 cases stage I (T1~T2) colorectal cancer from March 2005 to May 2008 at Cancer Hospital Chinese Academyof Medical Sciences, all the 18 cases were without high-risk features such as lymphovascular invasion, perineuralinvasion. Results Among the 18 patients, 12 (66.7%) were males and 6 (33.3%) were females. Before operation,15 patients had hemafecia, and 7 patients lost weight. Final histology revealed 2 (11.1%) lesions to be T1 and16 (88.9%) T2 cancers. 7 patients (38.9%) had local recurrence , and 9 patients (50.0%) had distant metastases,while 2 cases (11.1%) had lymph nodes metastases. After relapse, 11 cases (61.11%) had no symptoms. Amongthese patients, the mean overall survival was 57.6 months. Conclusions Regular postoperative surveillance instage I colorectal cancer is very important . It′s necessary to pay attention to their early symptoms after relapse.Early diagnosis, active treatment could potentially lead to an improvement in outcome.