多原发结直肠癌的临床特征和预后

目的探讨多原发结直肠癌的临床特征和预后。方法回顾性分析南京医科大学第一附属医院2013年1月至2018年12月收治的42例多原发结直肠癌患者的临床资料,对其临床病理特征、诊治及预后进行总结。结果符合多原发结直肠癌诊断的患者42例,占同期收治的所有结直肠癌患者的1.20%(42/3499),病理类型以腺癌为主。其中,同时性多原发癌32例,年龄38~86岁,中位年龄66岁,共发现73处结直肠癌灶,多位于近端结肠、乙状结肠及直肠;共检出淋巴结527枚,阳性10枚(1.9%),淋巴结阳性患者占同时性多原发癌的37.5%(12/32);27例为双原发癌,3例为三原发癌,2例为五原发癌;1、3年总生存率分别为83.75%和74.38%。异时性多原发癌10例,年龄33~86岁,第一癌多位于直肠和乙状结肠区域,第二癌多位于升结肠区域;共检出淋巴结276枚,阳性率12.3%(34枚),1、3年总生存率分别为100.00%和66.67%。结论多原发结直肠癌在临床上不少见,其分布有一定规律。临床中应引起重视,提高早期诊断率。应早期手术治疗以提高患者的生存率。

Clinical characteristics and prognosis of multiple primary colorectal carcinoma

Objective To explore the clinical characteristics and prognosis of multiple primary colorectal carcinoma.Methods The clinical data of 42 cases of colorectal cancer admitted to the First Affiliated Hospital of Nanjing Medical University between January 2013 and December 2018 were retrospectively analyzed.The clinicopathological features,diagnosis,treatment and prognosis were summarized.Results There were 42 patients with multiple primary colorectal carcinoma,accounting for 1.20%(42/3499)of all colorectal carcinoma patients in the same period.The main pathological type was adenocarcinoma.Among them,32 cases were synchronous multiple primary carcinoma.And the age ranged 38-86 years old,and the median age was 66 years old.A total of 73 colorectal cancer lesions were detected,mostly located in the proximal colon,sigmoid colon and rectum.A total of 527 lymph nodes were detected,and the positive rate was 1.9%(10).Patients with positive lymph nodes accounted for 37.5%(12/32),including 27 cases of multiple primary carcinoma,3 cases of triple primary carcinoma,2 cases of five primary carcinoma.The 1-year and 3-year overall survival rates were 83.75%and 74.38%,respectively.There were 10 cases of metachronous multiple primary carcinoma.Patients were aged 33-86 years old.The first cancer was mostly located in the rectum and sigmoid colon,and the second cancer was mostly located in the ascending colon area.A total of 276 lymph nodes were detected,and the positive rate was 12.3%(34).The 1-year and 3-year overall survival rates were 100.00%and 66.67%,respectively.Conclusions Multiple primary colorectal cancer is not rare clinically and its distribution shows a certain regularity.More attention should be paid to improve the early diagnosis rate.Early operation is needed to improve the survival rate of patients.