广东地区3870例大肠癌的临床流行病学特征

目的探讨广东地区大肠癌的临床特点和发病规律。方法总结分析广州南方医院和惠州市中心人民医院1985—2004年经病理确诊的3870例大肠癌的资料。结果3870例大肠癌患者中位年龄55．3岁。好发年龄为41～70岁。其中青年大肠癌（年龄≤30岁）204例,占5．3％。随年龄增长,直肠癌逐渐减少,而右半结肠癌逐渐增加。男：女为1．42：1。3870例共检测出3958个病灶,其中单病灶3783例（97．8％）,多病灶87例（2．2％）。3958个病灶部位分别位于直肠2243例（56．7％）,左半结肠717例（18．1％）,右半结肠998例（25．2％）。组织学分型为：管状腺癌2943例（76．0％）,乳头状腺癌256例（6．6％）,黏液癌425例（11．0％）,其他246例（6．4％）。青年大肠癌分化不良者占38．2％,而中年和老年大肠癌只占29．9％和14．6％,差异有统计学意义（P〈0．01）。确诊时Dukes分期A、B、C和D期分别占234例（6．0％）,1936例（50．0％）,1310例（33．9％）和390例（10．1％）,其中进展期癌（B、C、D期）共3636例,占94．0％。结论近20年问广东地区大肠癌的收治率逐渐增加,并随年龄增长,直肠癌比例逐渐减少,而右半结肠癌比例逐渐增加。半数大肠癌发生于直肠,其次为右半结肠和左半结肠。广东地区大肠癌已失去中国大肠癌既往的三大临床流行病学特点。

Clinical epidemiological characteristics of 3870 cases of colorectal cancers in Guangdong region

OBJECTIVE: To explore the clinical characteristics and pattern of incidence of colorectal cancers in Guangdong region. METHODS: Analysis and summary were made for 3870 colorectal cancer patients pathologically confirmed in the Nanfang Hospital and Huizhou Municipal Central Hospital of Guangdong province. RESULTS: Median age of 3870 cases with colorectal cancer was 55.3. The high-risk age ranged from 41 to 70.204 cases among them were young patients (age < or = 30, 5.3%). With increase of age the number of cases with rectal cancers decreased gradually, while cancers occurring in the right hemi colon increased gradually. The ratio between male and female was 1.42:1. There were altogether 3958 colonic cancer lesions found in all the cases. Among them 3783 (97.8%) cases presented with a single lesson, 87 (2.2%) cases presented with multiple lesions. 2243 (56.7%) lesions located in the rectum, 717 (18.1%) in the left hemi colon, 998 (25.2%) in the right hemi colon. Histological types in all the lesions cases were grouped as follows: tubular adenocarcinoma 2943 (76.0%); papillary adenocarcinoma 256 (6.6%); mucinous carcinoma 425 (11.0%); and miscellaneous types 246 (6.4%). Colorectal cancers with poor differentiation occurring in the young were 38.2% while in the middle age and the elderly were 29.9% and 14.6%, respectively. The difference between two groups showed a statistical significance (P < 0.01). The cases with confirmed stage A, B, C and D were 234 (6.0%), 1936 (50.0%), 1310 (33.9%) and 390 (10.1%), respectively, according to Dukes' staging system. The cases with the progressing stages (B, C, D stages) were 3636 (94.0%) among all the cases. CONCLUSIONS: The number of patients with colorectal cancer admitted in hospital increased gradually in the recent 20 years, and showed a trend with the decrease percentage in rectal cancer and the gradual increasing in right hemi colon cancer with increase of patients age. Half of the colorectal cancer occurred in the rectum, the rest occurred in the left and right hemi colon. The three clinical epidemiological characteristics of colorectal cancer, which once existed in Chinese, has disappeared in Guangdong region.