Ⅰ~Ⅲ期不同部位的左右半结肠癌临床病理特征及预后比较分析

Comparative analysis on the clinicopathological characteristics and prognosis of left and right colon cancer at stageⅠ-Ⅲ

目的对根治性切除术后不同分期、不同部位的结肠癌患者的临床病理特征及预后进行比较分析。方法回顾性分析2011年1月—2015年12月间蚌埠医学院第一附属医院476例行结肠癌根治性手术患者的临床病理资料,按照肿瘤部位不同分为左半结肠癌组(LCC组)257例和右半结肠癌组(RCC组)219例。对比2组患者的临床病理特征及5年总生存率,分析不同分期、不同部位的结肠癌患者的预后关系。结果结肠癌中男性所占比率高于女性(57.78%vs.42.22%)。其中,与RCC组相比,男性在LCC组中占比较高;与LCC组相比,女性在RCC组中占比较高。与LCC组相比,RCC组以贫血、腹部包块、肿瘤直径较大、中低分化腺癌为主,黏液腺癌及印戒细胞癌比例高,差异有统计学意义(均P<0.05)。而LCC组以便血或排便习惯改变为主要临床首发症状。2组患者在pTNM分期、pT分期、pN分期比较差异无统计学意义(均P>0.05)。LCC组与RCC组的5年总生存率分别为66.36%和64.29%(P>0.05)。在pTNMⅠ期中,LCC组5年总生存率为86.96%,RCC组5年总生存率为83.33%(P>0.05)。而在pTNMⅡ、Ⅲ期中,LCC组5年总生存率分别为65.89%、59.68%,RCC组5年总生存率分别为76.64%、44.16%(均P<0.05)。结论左右半结肠癌的临床表现和病理特征之间存在差异,两者5年总生存率差异无统计学意义。通过对亚组的分析,不同分期、不同部位的结肠癌患者的预后不同。

Objective To compare and analyse the clinicopathological characteristics and prognosis of patients with colon cancer at different stages and locations after radical resection.Methods The clinicopathological data of 476 patients undergoing radical surgery in the First Affiliated Hospital of Bengbu Medical College from January 2011 to December 2015 were retrospectively analysed.According to the different tumour locations,they were divided into the left colon cancer group(LCC group,257 patients)and right colon cancer group(RCC group,219 patients).The clinicopathological characteristics and 5-year overall survival rate of the two groups were compared,and the prognostic relationship of colon cancer patients of different stages and locations was analysed.Results The proportion of males was higher than that of females(57.78%vs.42.22%).Compared with the RCC group,the proportion of males in the LCC group was higher.The proportion of females in the RCC group was higher than that in the LCC group.Compared with the LCC group,the RCC group mainly had anaemia,abdominal mass,larger tumour diameters and moderately and poorly differentiated adenocarcinoma.The proportion of mucinous adenocarcinoma and signet ring cell carcinoma was high,the difference was statistically significant(P<0.05).In the LCC group,haematochezia and changes in defecation habits were the first main clinical symptoms.There was no statistical difference between the two groups in terms of pTNM stage,pT stage and pN stage(all P>0.05).The 5-year overall survival rates of the LCC and RCC groups were 66.36%and 64.29%,respectively(P>0.05).In stageⅠcancers,the 5-year overall survival rates of the LCC and RCC groups were 86.96%and 83.33%,respectively(P>0.05).In pTNM stageⅡandⅢcancers,the 5-year overall survival rates of the LCC group were 65.89%and 59.68%,respectively,whereas those of the RCC group were 76.64%and 44.16%(all P<0.05),respectively.Conclusion There are differences between the clinical manifestations and pathological characteristics of LCC and RCC.There is no significant difference in the 5-year overall survival rate between the two groups.Through the analysis of subgroups,the prognosis of colon cancer patients of different stages and different parts is different.