结直肠印戒细胞癌与黏液腺癌的临床病理分析

目的 比较结直肠印戒细胞癌和黏液腺癌临床病理特点.方法 回顾性分析1990年1月至2008年12月我院65例结直肠印戒细胞癌和166例结直肠黏液腺癌患者的临床病理资料及生存情况.结果 两者在性别、肿瘤大体分型、术前CEA水平、肝转移等方面相比,差异无统计学意义(P＞0.05);而在发病年龄、肿瘤部位、脉管瘤栓、淋巴结转移、肿瘤浸润深度、AJCC分期、术前肠梗阻、根治手术比例等方面比较,差异有统计学意义(P＜0.05).两组3年、5年生存率分别为56.7%、31.6%,其中印戒细胞癌组3年、5年生存率和中位生存期分别为33.1%、14.8%、24.0个月;黏液腺癌分别为64.1%、36.6%、41. 5个月,两组生存资料比较,差异均有统计学意义(均P＜0.05).病理类型是影响两组生存差异的独立危险因素.结论 结直肠印戒细胞癌较黏液腺癌具有恶性程度更高的生物学行为,患者生存状况更差.

Comparison of clinicopathological characteristics between colorectal signet-ring cell carcinoma and mucinous adenocarcinoma

Objective To compare the difference of clinicopathological characteristics between colorectal signet-ring cell carcinoma and mucinous adenocarcinoma. Methods The clinicopathological and survival data of 65 patients with colorectal signet-ring carcinoma and 166 with mucinous adenocarcinoma were retrospectively analyzed. Results Such clinical characteristics as gender, goss anatomical classification,preoperative carcinoembryonic antigen level and hepatic metastasis or not had no significant difference between two groups ( P ＞ 0. 05 ) while the difference of such characteristics as age, location of tumor,vascular tumor embolus, N stage, T stage, AJCC stage, preoperative obstruction and the ratio of radical resection between them was significant (P ＜ 0. 05 ). The overall 3, 5-year survival of the whole group was 56. 7% and 31.6% respectively. The 3, 5-year survival and median survival time (MST) in the signet-ring cell carcinoma and the mucinous adenocarcinoma groups were 33. 1 %, 14. 8%, 24. 0 months and 64. 1%,36. 6%, 41.5 months respectively. The pathological type of signet-ring cell carcinoma was an independent risk factor of survival in the whole group. Conclusion Compared to colorectal mucinous adenocarcinoma,signet-ring cell carcinoma has a higher degree of malignancy and the patients have a worse survival.