1474例不同年龄段结直肠癌患者的临床病理特征及预后分析

Clinicopathological features and prognosis of 1474 colorectal cancer patients of different ages

目的 分析不同年龄段结直肠癌患者的临床病理特征及预后相关因素。方法 选取2015年1月至2017年12月华中科技大学同济医学院附属协和医院结直肠癌患者1 474例行单中心回顾性研究。所有患者分为四组:A组(≤45岁)、B组(>45岁且<65岁)、C组(≥65岁且<75岁)和D组(≥75岁)。比较四组患者的临床病理特征及预后生存相关因素。结果 A组172例(11.67%),B组856例(58.07%),C组331例(22.46%),D组115例(7.80%)。不同年龄段结直肠癌患者在肿瘤最大直径、病理分化状态、肿瘤原发部位及微卫星不稳定状态方面比较,差异均具有统计学意义(均P<0.01)。A组和B组总生存均优于C组和D组(均P<0.05)。C组总生存优于D组(P<0.01)。D组无进展生存劣于其他各组(均P<0.01)。结论 年龄是影响结直肠癌病理特征和预后的重要影响因素,年龄<65岁是结直肠癌患者预后相对良好的因素,年龄≥75岁的结直肠癌患者预后不良。

Objective To analyze the clinicopathological features and prognostic factors of colorectal cancer patients of different ages.Methods A total of 1474 colorectal cancer patients in Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,from January 2015 to December 2017 were enrolled in a single-center retrospective study.They were divided into four groups:group A(age≤45 years old),group B(age>45 years old and<65 years old),group C(age≥65 years old and<75 years old)and group D(age≥75 years old).The clinicopathological features and prognostic factors in the four groups were compared.Results There were 172 cases(11.67%)in group A,856 cases(58.07%)in group B,331 cases(22.46%)in group C,and 115 cases(7.80%)in group D.There were statistically significant differences in maximum tumor diameter,pathological differentiation,primary tumor site and microsatellite instability(MSI)among colorectal cancer patients of different ages(all P<0.01).The overall survival of groups A and B was better than that of groups C and D(all P<0.05).The overall survival of group C was better than that of group D(P<0.01).Progression-free survival(PFS)of group D was worse than that of the other groups(all P<0.01).Conclusions Age is an important factor affecting the pathological characteristics and prognosis of colorectal cancer.Age<65 years old is a relatively good prognostic factor for colorectal cancer patients,and patients at age of≥75 years old have a poor prognosis.