青年与老年结直肠癌临床特点比较

Comparison of clinical features among young and elderly patients with colorectal cancer

目的:比较青年与老年结直肠癌临床特点。方法:回顾性分析2014年10月至2017年9月期间的141例青年(年龄<40岁结直肠癌和同期确诊的542例老年(年龄≥60岁且<80岁)结直肠癌患者的临床资料。比较两组癌胚抗原检出率、首发症状、家族史、误诊率、行根治性手术的例数、发病部位、分化程度、TNM分期、淋巴结转移和癌变类型等临床特点。结果:两组性别及癌胚抗原检出率比较,差异无统计学意义(P>0.05);首发症状,青年组以便血最多见,老年组以腹痛最多见,无症状患者明显多于青年组,差异均有统计学意义(P<0.05);青年组有家族史、误诊率、行根治性手术的例数均明显高于老年组,差异均有统计学意义(P<0.05)。两组的肿瘤分型及肿块直径比较,差异无统计学意义(P>0.05)。青年组发病部位最多的是直肠,老年组最多的是左半结肠;青年组最多的是中分化癌,老年组最多的是高分化癌;青年组TNM分期最多的是Ⅱ期,老年组最多的是Ⅰ期;两组无淋巴结转移和远处转移的患者均较多,且老年组明显多于青年组;组织学类型上,老年组更多的是腺癌,青年组更多的是印戒或黏液癌,以上数据差异均有统计学意义(P<0.05)。结论:青年结直肠癌患者误诊率高、恶性程度高,易早期淋巴结转移及远处转移;老年结直肠癌患者早期症状不明显,最终行根治性手术比例相对青年组低。

Objective: To compare clinical features among young and elderly patients with colorectal cancer. Methods: The clinical data of 141 young patients with colorectal cancer (admitted in Xinjiang Uygur Autonomous Region People’s Hospital from October 2014 to September 2017) and 542 elderly patients with colorectal cancer (diagnosed at the same time period, age ≥ 60 and<80 years) were retrospectively analyzed. The clinical features of carcinoembryonic antigen detection rate, first symptom, family history, misdiagnosis rate, number of radical surgery, lesion location, differentiation, TNM stage, lymph node metastasis and cancerization type were compared between the two groups. Results: There was no significant difference in the gender and carcinoembryonic antigen detection rate between the two groups (P>0.05). For the first symptom, Hematochezia was common in the young group, while abdominal pain was the most common symptom in the elderly group;the number of the asymptomatic patients in the elderly group were significantly more than that in the young group;and the differences were statistically significant (P<0.05). The number of the patients with family history, misdiagnosis rate, and radical surgery in the young group was significantly higher than that in the elderly group, and the difference was statistically significant (P<0.05). There were no significant differences in the tumor classification and tumor diameter between the two groups (P>0.05). The most common location of the young group was the rectum, while that of the elderly group was the left colon. The moderately differentiated carcinoma was the most in the young group, while the highly differentiated carcinoma was the most common lesion in the elderly group. In the youth group, the TNM stage II was the most, while in the elderly group, stage I was mostly seen. There were more patients with no lymph node metastasis and distant metastasis in the two groups, and those of the elderly group were significantly more than those of the young group. In the histological type, the elderly group had more adenocarcinoma, while the young group suffered from more signet cell carcinoma or mucous cancer. There were statistical differences in the above data (P<0.05). Conclusions: Young patients with colorectal cancer have high misdiagnosis rate and high degree of malignancy, and are prone to lymph node metastasis and distant metastasis;Whereas, the early symptoms of the elderly patients with colorectal cancer are not obvious, and the proportion of radical surgery is lower than that of the young group.