187例血吸虫病结直肠癌患者的构成分析与实验室检查特点

Composition and Laboratory Examination Characteristics of 187 Colorectal Cancer Patients with Schistosomiasis

目的分析日本血吸虫病是否与结直肠癌的发生有一定相关性及血吸虫病结直肠癌的特征。方法回顾性分析2013年1月—2017年12月皖南医学院弋矶山医院收治的187例血吸虫病结直肠癌患者的临床资料、病理学与实验室检查结果,同期2597例单纯结直肠癌患者作为对照,并统计分析。结果血吸虫病结直肠癌患者中,男性显著多于女性(P=0.002),平均年龄为(64.79±10.91)岁,显著大于单纯结直肠癌组(61.63±11.86)岁(P=0.001),尤其在60岁以后(P=0.007)。两组红细胞数量均低于正常值(P=0.01);血吸虫病结直肠癌患者中粪便隐血阳性数为119例(63.64%),显著高于单纯结直肠癌组(51.75%)(P=0.002);血吸虫病结直肠癌患者与单纯结直肠癌患者CEA与CA199的水平均明显高于正常值。结论血吸虫病结直肠癌具有一定临床特征。对于血吸虫疫区居民,尤其是中老年男性,建议定期行血清肿瘤标志物及消化道内镜等检查,尽早发现合并消化道肿瘤的可能。

Objective To analyze whether schistosomiasis japonica has a certain correlation with the occurrence of intestinal cancer and investigate the characteristics of intestinal cancer with schistosomiasis. Methods We retrospectively analyzed the clinical data, pathological and laboratory examination results of 187 colorectal cancer patients with schistosomiasis treated in Yijishan Hospital of Wannan Medical College from Jan. 2013 to Dec. 2017. In addition, 2597 colorectal cancer patients without schistosomiasis were included as control group in the same period. Results Among these patients with schistosomiasis, males were significantly more than females (P=0.002);the average age was significantly higher than the control group (64.79±10.91) vs.(61.63±11.86) years old, P=0.001), especially after 60 years old (P=0.007). The number of red blood cells in both groups was lower than the normal value (P=0.01). The positive number of fecal occult blood in colorectal cancer patients with schistosomiasis was significantly higher than that in the control group (119 (63.64%) vs. 1344 (51.75%), P=0.002). The levels of CEA and CA199 in both groups were significantly higher than normal value. Conclusion Colorectal cancer with schistosomiasis has clinical characteristics. For the residents in schistosomiasis endemic areas, especially middle-aged and elderly men, it is suggested that serum tumor markers and gastrointestinal endoscopic examination should be performed regularly to detect the possibility of schistosomiasis combined with digestive tract tumors as early as possible.