结直肠癌2042例临床病理特点及预后回归分析

目的 探讨广东地区结直肠癌的临床病理特点和影响预后的因素.方法 总结中山大学附属第一医院1995-2007年经病理确诊的2042例结直肠癌的临床资料,分析其临床特点和预后情况.结果 2042例患者的中位年龄为59岁,好发年龄为50～70岁.男女比例为1.4:1.直肠是最常见部位,占46.2%,其次为乙状结肠,占22.0%.年龄<40岁患者黏液癌占16.7%,而低分化癌占33.5%,比例明显高于40岁以上患者.根据TNM分期,Ⅰ期占5.8%,Ⅱ期占42.9%,Ⅲ期占31.0%,Ⅳ期占20.3%.结直肠癌总体生存率1年为92.3%,3年为73.9%,5年为65.1%,10年为57.5%.年龄、大体分型、分化程度、TNM分期和手术方式是影响结直肠癌患者生存的独立危险因素,辅助化疗是保护因素.1995-2001年(第Ⅰ阶段)与2002-2007年(第Ⅱ阶段)比较,第Ⅱ阶段中使用吻合器、直肠癌行Dixon手术和化疗的比例增高,第Ⅱ阶段1、3、5年生存率分别为93.4%、78.0%、73.2%,明显高于第Ⅰ阶段(90.6%、69.2%、58.8%).结论 年龄、大体分型、分化程度、TNM分期、手术方式和辅助化疗是影响结直肠癌患者生存的重要因素.

Regression analysis of the characteristics and outcome of colorectal cancer 1995 - 2007

Objective To explore the clinical characteristics and the prognostic factors of patients with colorectal cancer. Methods The data of 2042 cases of colorectal cancer, pathologically confirmed at our hospital from January 1995 to December 2007, were summarized and analyzed. Results The median age of all cases with colorectal cancer was 59 years old. The high-risk age ranged from 50 to 70 years old. The ratio of male and female was 1.4: 1. The lesions located in rectum accounted for 46.2% and those for 22.0% in sigmoid. Patients under age 40 had a higher percentage of poor differentiation (33.5%) and mucinous carcinoma(16.7%).The cases with confirmed stage Ⅰ,Ⅱ,ⅢandⅣwere 5.8%,42.9%,31.0%and 20.3%respectively.For all cases,the 1-,3-,5-and 10-year sunrvival rates were 92.3%,73.9%.65.1%and 57.5%respectively.The independent risk factors for patient prognosis were age,gross type,differentiation,TNM staging and surgical type.Adjuvant chemotherapy was a protective factor.As compared with phase Ⅰ(1995-2001),phaseⅡ(2002-2007)had a higher pmportions of employing stapler,Dixon operation and adjuvant chemotherapy.The 1-,3-and 5-year survival rates of phase Ⅱ were higher than phase Ⅰ(93.4%,78.0%and 73.2%vs 90.6%,69.2%and 58.8%).Conedusion The prognostic factors of patients with colorectal cancer are age, gross type, differentiation, TNM staging, surgical type and adjuvant chemotherapy.