青年期直肠癌的临床病理学特征探讨

Discussion of clinical pathology character of rectal cancer in adolescence.

目的 探讨青年期直肠癌的临床病理学特征 ,以提高其治疗水平。方法 回顾性分析 1975～ 2 0 0 1年收治的青年期直肠癌的发生部位、大体类型、组织学类型和淋巴结转移等病理学特征 ,并观察其预后。结果 青年期直肠癌占同期全部直肠癌的 6 2 % (15 8/ 2 5 3 8) ,1990年前后的比例分别为 10 2 %及 3 9% ,79 3 %位于腹膜返折以下 ,浸润型者占 75 9% ,粘液腺癌及低分化腺癌占 76 5 % ,侵犯浆膜者占 74 1% ,淋巴结转移者为64 6%。这些特点与壮老年直肠癌相比差异均具有非常显著性意义 (P <0 0 1)。青年期直肠癌的预后极差 ,五年生存率仅 2 1 5 % (3 4/ 15 8)。结论 青年期直肠癌有一系列不同于壮老年的临床病理学特征 ,预后差 ,其治疗水平有赖于提高对这些特征的认识 。

Objective To study the clinical pathological characters of adolescence rectal cancer and try to raise the therapeutic level. Methods The clinical pathological characters of adolescence rectal cancer such as position, type, histological type, lymph node metastasis were analyzed retrospectively.These patients were addmitted from 1975～2001 in our hospital,and the prognosis was observed.Results Six point two percent(158/2538) of rectal cancer patients were adolescence,10 2% were before 1990 and 3 9% after 1990,79 3% were below peritoneum reflex,75 9% were invasive type,76 5% were mucinous and low differentiated adenocarcinoma.Serosa was involved in 74 1%, lymphatic metastasis was found in 64 6% of the patients.There was significant difference (P<0 01) between the characteristics of the rectal cancer in the adolescence and that in the old. The rectal cancer in adolescence had a bad prognosis and the 5-year-survival rate was 21 5%(34/158).Conclusion The rectal cancer adolescence has some clinical characteristics that are different from those in middle-aged and old people,and adolescence rectal cancer has bad prognosis. The therapeutic effects depend on paying attention to these clinical pathologic characteristics and early diagnosis and treatment.