中青年与老年结直肠癌患者临床病理特征比较

背景：近年我国结直肠癌发病率呈持续上升趋势,且发病年龄早于西方国家.目的：探讨中青年与老年结直肠癌患者临床、病理特征的差异.方法：选取2005年1月～2010年11月于上海曙光医院宝山分院确诊的结直肠癌患者,根据年龄分为中青年组（≤60岁）和老年组（＞60岁）,对两组临床、病理资料进行回顾性分析.结果：79例中青年和158例老年结直肠癌患者纳入研究.两组均以男性和直肠癌为主.与老年患者相比,中青年患者有肿瘤家族史者比例较高,多以血便或排便习惯改变为首发症状,贫血发生率较低,确诊时间较短,肿瘤Dukes分期和组织学类型与老年患者无明显差异.结论：中青年结直肠癌患者的发病受遗传因素影响大,首发症状与老年患者有明显差异,病理特征与老年患者相似.对可疑病例应及早行结肠镜检查.

Comparison of Clinical and Pathological Characteristics of Colorectal Cancer in Young to Middle-aged and Elderly Patients

Background: The incidence of colorectal cancer in China increases continuously in recent years,and the age ofonset is earlier than western world.Aims: To investigate the differences of clinical and pathological characteristics ofcolorectal cancer in young to middle-aged patients with elderly patients.Methods: Patients confirmed as havingcolorectal cancer from Jan.2005 to Nov.2010 in Shanghai Shuguang Hospital Baoshan Branch were enrolled,and thenwere divided into young to middle-aged group(≤60 years) and elderly group(>60 years).The clinical features andpathology of colorectal cancer in these two groups were analyzed retrospectively.Results: Seventy-nine young to middle-aged and 158 elderly patients were enrolled.Male and rectal cancer were predominant in both groups.Compared with theelderly group,the young to middle-aged group had greater proportion of family history,lower rate of anemia,shorter timeto make diagnosis,and bloody stools and change of bowel habit as the early presenting symptoms.No significantdifferences were observed in Dukes stage and histological type between these two groups.Conclusions: Hereditary factormight play a crucial role in the pathogenesis of colorectal cancer in young to middle-aged patients.The early presentingsymptoms in young to middle-aged patients are different from those of elderly ones,whereas the pathological characteristicsare similar.Colonoscopy should be performed early in suspected subjects.