不同部位结肠癌的临床病理特征及预后的对比分析研究

The Comparative analysis of clinical pathological characteristics and prognosis of different parts of colon cancer

目的对比分析左侧结肠癌与右侧结肠癌的临床症状、病情特征及预后情况。方法分析2009年2月至2013年7月间在我院接受诊断治疗的257例结肠癌患者,根据发病部位的不同,将结肠癌患者分成A组(左侧结肠癌患者101例)和B组(右侧结肠癌患者156例)两组,比较两组患者的首发临床症状、病理及生存情况。结果 A组患者的排便习惯及粪便性状上的改变相较于B组有明显改变;腹胀腹痛发生率明显低于B组(P<0.05),两组患者的肿瘤直径、大体形态及病理类型分布均差异显著(P<0.05),A组患者的肝脏转移及淋巴结转移发生率均明显低于B组(P<0.05),一年生存率A组(89.1%)和B组(85.9%)相比较无统计学意义(χ2=0.565,P=0.45); A组5年生存率(56.4%)明显高于B组(42.3%)(χ2=4.904,P=0.03)。结论与左侧结肠癌相比,右侧结肠癌的恶性程度更高,易出现肝脏及淋巴结转移,且预后情况较差。

Objective To compare and analyze the clinical symptoms,disease characteristics and prognosis of distal colon cancer and proximal colon cancer.Methods Clinical data of 257 patients with colon cancer received treatment in our hospital from February,2009 to July,2013 was retrospectively analyzed.Patients were divided into two groups according to the different parts of colon cancer,group A(distal colon cancer,101 cases)and group B(proximal colon cancer,156 cases).The initial symptom,pathology and survival situation in two groups were compared.Results The rate of changes in stool habits and traits in group A was obviously higher than that in group B(P<0.05).The tumor diameter,gross tumor morphology and pathological type distribution in two groups had statistical difference(P<0.05).The occurrence rates of liver metastasis and lymph node metastasis in group A were obviously lower than those in group B(P<0.05).The one year survival rate in group A(89.1%)was higher than that in group B(85.9%),but had no statistical difference(χ^2=0.565,P=0.45).The five year survival rate in group A(56.4%)was higher than that in group B(42.3%)(χ^2=4.904,P=0.03).Conclusion Compared to distal colon cancer,the tumor grade malignancy of proximal colon cancer was worse,the occurrence rates of liver metastasis and lymph node metastasis were higher,and the prognosis was worse.