107例青年大肠癌临床病理特征与预后

目的 :探讨青年人大肠癌的临床、病理特征与预后。方法 :总结该院 1986年 5月～ 2 0 0 2年 5月间收治的30岁以下青年人大肠癌 10 7例 ,分析其临床特点、病理特征和生存率。结果 :10 7例青年人大肠癌中 ,平均病程 5 .5月 ,误诊 84例 ,占 78.5 % ,误诊以肠炎、痔疮、痢疾多见。Dukes分期 :C ,D期共 82例 ,占 76 .6 %。病理类型以低分化、未分化、黏液腺癌、印戒细胞癌和恶性淋巴瘤多见 ,共 6 1例 ,占 5 7.0 %。 70 /10 7(6 5 .4 % )行根治性手术 ,5年随访生存 2 0 /70例 (2 8.6 % )。结论 :青年人大肠癌确诊晚 ,误诊率高 ,病理特征恶性程度高 ,预后差。如何早诊和早治是提高生存率的关键。

CLINICAL PATHOLOGICAL ANALYSIS IN 107 CASES OF YOUNG PATIENTS WITH COLON CANCER

Objective:To study the clinical pathological feature and prognosis in 107 cases of young patients (age<30) with colon cancer. Methods:Applying statistic methods, we analyzed the clinical pathological feature and survival rate of 107 cases of young patients with colon cancer from May 1998 to May 2002 in Zhongshan hospital.Results:The mean duration from onset of symptoms to diagnosis in this group was 5.5 months. Eighty-four of 107 were misdiagnosed. The misdiagnosis rate was 78.5%. They were often misdiagnosed as bacillary dysentery,hemorrhoid and enteritis. Dukes stages C and D was noted in 82 cases (76.6%). The proportion of poorly differentiated adenocarcinoma, undifferentiated adenocarcinoma, mucinous carcinoma, signet-ring cell carcinoma and malignant lymphoma was 57.0%(61/107).The 5-year survival rate in complete resection group was 28.6%(20/70).Conclusion: The young patients with colon cancer have the characteristic of high misdiagnosis rate , high incidence of poor differentiation, more advanced stages and poor prognosis. In order to raise the survival rate, it is important for us to diagnosis and treat the young adults with colon cancer as early as we can.