不同病理类型的左右半结肠癌预后分析

目的 探讨不同病理类型的左、右半结肠癌的预后.方法 将2005年1月至2010年12月东莞市人民医院收治的386例结肠癌患者按照肿瘤病理分型分为A组(低/未分化腺癌+黏液腺癌+印戒细胞癌)152例、B组(高/中分化腺癌)234例;同时按肿瘤部位分为右半结肠癌和左半结肠癌.分析肿瘤不同临床病理分型及部位与患者预后的关系.结果 A组患者肿瘤TNM分期、T分期、N分期及血清癌胚抗原水平均显著高于B组患者(P<0.05);右半结肠癌患者T分期及N分期均显著高于左半结肠癌患者(P<0.05);A组病理类型在右结肠癌中更常见(P<0.05).A组患者5年生存率52.43%低于B组55.77%(P<0.05);右半结肠癌患者的5年生存率53.66%也低于左半结肠癌患者55.24%(P<0.05).在A组患者中,右半结肠癌的5年生存率高于左半结肠癌(52.82% vs 50.71%,P<0.05);而在B组患者中,右半结肠癌与左半结肠癌的5年生存率差异无统计学意义(56.14% vs 54.27%,P>0.05).结论 在低分化腺癌/黏液癌/印戒细胞癌中,右半结肠癌患者的预后好于左半结肠癌;而在高/中分化的腺癌中,右半结肠癌患者的5年生存率较左半结肠癌呈降低趋势.

Relationship between pathological classification, tumor location and prognosis of colon cancer

Objective To investigate the prognosis of different pathological types of left and right colon cancer.Methods A total of 386 patients with colon cancer in Dongguan People's Hospital from Jan 2005 to Dec 2010 were divided into group A (low/undifferentiated adenocarcinoma and mucinous adenocarcinoma and ring cell carcinoma, 152 cases) and group B(high/middle differentiated adenocarcinoma, 234 cases);meanwhile, according to the location of the tumor, the patients were divided into group of right side colon cancer and left side colon cancer.Then the relationship between different clinical pathological types and location and prognosis of patients were analysed.Results The TNM stage, T stage, N stage and serum CEA level were significantly higher in group A than those in group B (P<0.05).Type A was more common in right colon cancer (P<0.05).The five year survival rate of patients in group A was 52.43%, which was lower than that in group B 55.77% (P<0.05).The five year survival rate of patients with right colon cancer(53.66%) was lower than that in patients with left colon cancer(55.24%)(P<0.05).In group A, the five year survival rate of right colon cancer was higher than that of left colon cancer (52.82% vs 50.71%,P<0.05), while in group B, there was no difference between them(56.14% vs 54.27%,P>0.05).Conclusion In the low differentiated adenocarcinoma/mucinous carcinoma / signet ring cell carcinoma, the prognosis of right colon cancer is better than left colon cancer;however, the trend is opposite in the high/middle differentiated adenocarcinoma.