结直肠癌患者的临床、内镜、病理学特点

目的探讨结直肠癌患者临床、内镜、病理特点。方法对1991—2005年肠镜及病理证实的结直肠癌患者,按年龄分为青年组(≤30岁),中年组(31~59岁),老年组(≥60岁),从临床表现、内镜表现和病理学三方面进行回顾性分析。结果(1)本组结直肠癌患病高峰为50~65岁,男性结直肠癌构成比高于女性。(2)青年组以腹痛就诊者占70.73%,中老年组以便血就诊者占65.50%,说明临床症状具有不典型性。(3)各组直肠癌均有较高的比例,青年组右半结肠癌的发病率(34.15%)明显高于中老年组(16.33%)。(4)青年组以低分化腺癌、黏液腺癌为多,肿瘤分化程度低,恶性程度高;中老年组以高分化腺癌多见,肿瘤分化程度高,恶性程度低。结论不同年龄组结直肠癌患者有不同的临床、内镜、病理特点,对有下消化道症状的患者,应尽早、全面地进行结肠镜检查。

Analysis on Clinical, Endoscopic and Pathologic Characteristics of Patients with Colorectal Cancer

Objective To explore the clinical, endoscopic and pathologic characteristics of the patients with colorectal cancer.Methods The patients with colorectal cancer from 1991 to 2005, who were proved by enteroscope and pathologic diagnosis, were enrolled into the study. According to their age, the patients were divided into young group (≤30 years), mid-aged group (31-59 years) and aged group (≥60 years). Their clinical manifestation, endoscopic appearance and pathologic data were analyzed retrospectively. Results (1) The incidence peak of colorectal cancer occurred at the age of 50~65 years in the study, and males were predominant. (2) The dominant abdominal pain was the main symptom in the young group (70.73%), but the bloody stools were the main symptom in the mid-aged and aged groups (65.50%), which showed that the patients' clinical symptoms are atypical. (3) Rectal carcinoma was predominant in all the three groups. Occurrence rate of right colonic cancer were higher in the young group (34.15%) than in the mid-aged group and the aged group (16.33%). (4) The pathological type of the young group mainly included mucinous adenocarcinoma and low-differentiated adenocarcinoma, whose pathological differentiation was lower and prognosis was worse than that of the mid-aged group and aged group. Conclusion Different age groups with colorectal cancer are characteristic of different clinical, endoscopic and pathologic manifestation, so one needs to receive endoscopic examination as early as he could if he suffers from lower alimentary canal symptoms.