广东地区2 037例大肠癌临床病理分析

Clinicopathological analysis of 2 037 patients with colorectal cancer in Guangdong Province

目的探讨广东地区大肠癌发病特点.方法统计南方医院1986～2002年经病理确诊的所有大肠癌病例并进行分析.结果17年共收治大肠癌2 037例,其中男性患者1 165(57.19%)例、女性患者872(42.81%)例,男女比例为1.34:1.41～70岁为发病高峰(70.74%).发病人数从1994年来呈现较快增长的趋势.直肠仍为大肠癌的最好发部位(55.87%),但结肠癌有明显上升趋势(44.13%).与中老年大肠癌病人相比,青年病人(年龄≤40岁)右半结肠癌发生率较高.根据Dukes分期,B、C和D三期病例共占96.17%,表明大肠癌患者就诊时大部分已为中、晚期.组织学类型主要为高、中分化腺癌(71.18%),而低分化癌、粘液癌也有较高比例(21.11%).青年大肠癌以低分化癌及粘液癌居多(35.96%),远高于中老年患者(12.74%),按Dukes分期则以C、D两期所占比例多.结论该地区大肠癌呈较快增长趋势,且患者就诊时多为中晚期.由于青年大肠癌多具有家族遗传倾向,因此对大肠癌应早发现、早诊断、早治疗,从而提高病人生存率.

Objective To study the clinicopathological characteristics of colorectal cancer in Guangdong Province. Methods Statistical analysis was conducted in the 2 037 cases of colorectal cancer treated in Nanfang Hospital of First Military Medical University from 1986 to 2002. Results The patient cohort consisted of 1 165 males (57.19%) and 872 females (42.81%), with a male to female ratio of 1.34∶1. The high-risk age range for colorectal cancer was 41-70 years (making up 70.74% of the total patients). The annual number of newly identified patients began to rise in 1994, and the rectum still remained the most frequently involved site (55.87%), but colonic cancer tended to increase (44.13%). Compared with their seniors, young patients (age≤40) were prone to be affected by right colonic cancer. Dukes staging showed that most of the patients were in middle or advanced stages (96.17%), and most cases were histologically identified as adenocarcinoma (71.18%), but a poorly differentiated carcinoma was more likely to be found in young patients (35.96%) than in their elders (12.74%). Conclusions The incidence of colorectal cancer increases annually and most of the identified cases are in middle or advanced stages. Many young patients have a hereditary predisposition and the knowledge of prevention and self-protection of colorectal cancer is of significant value. Screening and early diagnosis and early treatment may help improve the survival rate among the high risk population.