结直肠多原发癌和结直肠癌合并其他器官恶性肿瘤临床分析

目的进一步探讨结直肠多原发癌和结直肠癌合并其他器官恶性肿瘤的临床特点。方法回顾性分析4178例手术治疗的结直肠癌患者的临床资料。结果本组病例中,同时或异时结直肠多原发癌134例,占3.2%;结直肠癌合并其他器官恶性肿瘤39例,占0.9%。结直肠多原发癌伴结直肠腺瘤96例,占71.6%,以管状腺瘤多见,全结直肠纤维镜检查可使其术前检出率从48.3%(1990年以前)提高到91.4%(1990年以后),1990年后行术后结肠镜检查并及时治疗结直肠腺瘤使术后异时癌的发生率由1.5%降至0.7%。结论结直肠多原发癌和结直肠癌合并其他器官恶性肿瘤发病率较高。应注重术前行全结直肠纤维镜检查,术中全面探查和术后随访。

Clinical analysis of multiple primary colorectal cancer and colorectal cancer accompanied by cancer of other organs

Objective To evaluate the clinical characteristics of multiple primary colorectal cancer (MPC) and colorectal cancer accompanied by cancer of other organs. Methods Clinical data of 4 178cases with colorectal cancer treated with surgery were analyzed retrospectively. Results 134 cases (3.2%) were found as synchronous or metachronous MPC, and 39 cases (0.9%) accompanied by cancer of other organs. 96 cases with MPC(71.6%)were accompanied with colorectal adenomas. Fibroptic total colonoscopy increased the preoperative diagnostic rate (91.4%) after 1990 , was significantly higher than that (48.3%) before 1990, The incidence of metachronous MPC decreased from 1.5%to 0.7%by postoperative fibroptic colonoscopy and treatment of colorectal adenomas in time. Conclusions The incidence of multiple primary colorectal cancer and colorectal cancer accompanied by cancer of other organs is high. It is important to perform the fibroptic colonoscopy examination before operation, careful exploration during operation and follow up after operation.