40岁以下青年直肠癌的临床分析

目的 探讨40岁以下青年直肠癌的临床病理特征、治疗方法及预后.方法 将6年间收治的已切除且有完整手术资料的325例直肠癌患者分为2组:青年组(<40岁)49例;中老年组(≥40岁)276例,对2组的临床病理、治疗方法及随访资料进行回顾性分析.结果 青年直肠癌占同期直肠癌的15.1%(49/25),中下段占79.6%(39/49),浸润生长占55.1%(27/49),黏液腺癌及低分化占83.7%(41/49),侵犯浆膜者占87.8%(43/49),淋巴结转移者占75.5%(37/49),Miles手术占65.3%(32/49),Dixon手术占34.7%(17/49).上述特点与中老年直肠癌均有显著差异(P<0.01).5年生存率青年组为32.7%,中老年组为60.9%,差异有统计学意义(P<0.01).结论 青年直肠癌的临床病理特征及预后较差,与中老年者有明显不同的特征.临床要提高警惕,以便早发现、早诊断、早治疗.

Clinical analysis of rectal cancer in patients younger than 40 years old

Objective:To investigate the clinicopathological characteristics, treatment Methods: and prognosis of rectal cancer in patients younger than 40 years old.Methods: From Jan, 1998 to Dec, 2003, 325 treated rectal cancer patients with complete surgical records were divided into two groups: young patients group (younger than 40 years old) 49 patients, accounted for 15.1%; middle and old patients group (older than 40years old) 276 patients, accounted for 84.9%. The clinicopathological characteristics, treatment Methods: and follow-up data were compared. Results:Among the younger patients, cancer in middle and lower segments of rectum accouned for 79.6%(39/49), infiltrative cancer accounted for 55.1%(27/49), mucous and low-differentiated cancer accounted for 83.7%(41/49), cancer invasion of serosa occurred in 87.8%(43/49), lymph node metastasis in 75.5%(37/49), Miles operation was performed in 65.3%(32/49) and Dixon operation in 34.7%(17/49). These characteristics differewed significantly from middle-aged and old patients. And the 5-year survival-rate in youn patient group was 32.7% and in middle and old patient proup was 60.9% respectively, (P＜0.01). Conclusions:The clinicopathological characteristics and prognosis of rectal carcinoma in younger patients differs markedly from those of middle-aged and older patients, and therefore we should be more vigilant in order to discover,detect and treat the younger patient as early as possible.