昆明地区结直肠肿瘤260例

目的:分析单中心收治的结直肠肿瘤患者的临床特点,为临床诊治提供参考.方法:回顾分析我院2010年经外科手术确诊的260例原发性大肠肿瘤患者临床资料,探讨确诊大肠肿瘤临床特点及其与吸烟、饮酒和既往病史等可能影响其发生发展的因素的关系.结果:大肠肿瘤患者的男女比例为1.24∶1,平均年龄61.73岁±11.56岁.好发部位依次为直肠、乙状结肠、升结肠、横结肠和降结肠,同时性多发癌8例.64.23%的直肠肿瘤距肛门≤8cm,男性直肠肿瘤距肛门的距离(8.22cm±3.35cm)明显大于女性(7.08cm±2.09cm,t=2.20,P=0.03).直肠和左半结肠以大便带血为主,右半结肠以腹痛腹胀为主,大便潜血阳性率为80.43%.DukesA期比例升至18.85%,分化程度和年龄负相关(r=-0.145,P=0.019).胆囊切除术后患者右半结肠肿瘤比例高(P>0.05),高血压病史患者器官转移比例低(P<0.05).结论:直肠指诊和大便隐血实验是重要的检查方法;大便带血和腹胀腹痛分别是左半结肠、直肠和右半结肠的主要症状;大肠肿瘤早期诊断率呈增高趋势;年龄、胆囊切除术和高血压病可能是影响大肠肿瘤发生发展的因素.

Clinical characteristics of colorectal neoplasms:A retrospective analysis of 260 cases

AIM:To investigate the clinical characteristics of colorectal neoplasms so as to provide the basis for clinical diagnosis and treatment. METHODS:The clinical data for 260 patients with primary colorectal neoplasms diagnosed surgically and pathologically in 2010 at our hospital were analyzed retrospectively. The clinical features for colorectal neoplasms and the association of smoking,drinking and past medical history with tumor progression were analyzed. RESULTS:Male/female ratio was 1.24:1,and the average age was 61.73 ± 11.56 years. The incidences by tumor site ranked in descending order were the rectum,the sigmoid colon,the as-cending,transverse and descending colons. Syn-chronized carcinomas of the colon and rectum were found in 8 cases. Approximately 64.23% of rectal neoplasms were located within 8 cm to the anus. The average length was significantly longer in male cases than in female cases (8.22 cm ± 3.35 cm vs 7.08 cm ± 2.09 cm,t = 2.20,P = 0.03). Bloody stools was the main symptom of left-sided colonic and rectal neoplasms,while abdomi-nal pain and abdominal distension were main symptoms of right-sided colonic neoplasms. The positive rate of fecal occult blood test (OBT) was 80.43%. The ratio of cases in Dukes stage A was 18.85%. Tumor differentiation degree was negatively correlated with age (r =-0.145,P = 0.019). The incidence rate of right-sided colonic neoplasms among cholecystectomy patients was higher than left-sided ones but the difference was not statistically significant (P > 0.05). The incidences of metastasis and infiltration among essential hypertension patients were lower (both P < 0.05). CONCLUSION:Digital rectal examination (DRE) and OBT are two important methods for find-ing colorectal neoplasms. Bloody stools and ab-dominal pain,abdominal distension are the main symptoms of right-and left-sided colonic neo-plasms,respectively. There is an increased trend in early diagnosis. Age,cholecystectomy and es-sential hypertension may relate to pathogenesis and development of colorectal neoplasms.