胆石症并发原发性大肠癌临床分析

发布时间：2018-11-11 19:05

【摘要】：目的： 探讨胆石症并发原发性大肠癌者临床特点。 材料和方法： 本研究随机选取2011年11月至2013年12月期间于吉林大学白求恩第一医院经术后病理明确诊断为大肠癌，其中经腹部CT或（和）消化系彩超明确诊断为胆石症患者共65人，不合并胆道系统疾病者65人。从发病年龄、性别、癌灶数目、发病部位、病理类型、分化程度、分期进行比较。应用SPSS17.0统计软件进行数据分析。 结果： 1.胆石症并发大肠癌组患者男女比例较大肠癌组低，但其差异无统计学意义（P＞0.05）。 2.胆石症并发大肠癌组患者以55~79岁年龄段所占比例最高，占75%以上，中位年龄为68岁；大肠癌组患者以45~74岁年龄段所占比例最高，占75%以上，中位年龄为59岁，两者中位年龄比较差异有统计学意义（P＜0.01）。胆石症并发大肠癌组老年患者与大肠癌组比较具有显著差异（P＜0.01）。 3.胆石症并发大肠癌组患者中多原发癌4例，与大肠癌组比较无统计学差异（P＞0.05）。 4.胆石症并发大肠癌组患者病理类型以腺癌最多见，其次为粘液腺癌，这与大肠癌组相似（P＞0.05）。 5.胆石症并发大肠癌组低（未）分化病灶13个，占18.84%，，高于大肠癌组的7.35%，差异具有统计学意义（P＜0.05）。 6.胆石症并发大肠癌组晚期患者较大肠癌组高，其中处于Ⅲ期患者两组间有显著性差异（P＜0.01）。 结论： 1.60岁以上胆石症患者发生大肠癌危险性增高，而与性别无明显相关性。提示我们60岁以上胆石症患者，尤其是胆石症病程较长者，应该定期进行肠道检查。 2.胆石症患者右半结肠癌发病率高。 3.胆石症并发大肠癌组织倾向于低分化，发生局部淋巴结转移者明显增多，表明胆石症并发的大肠癌侵袭性较强。
[Abstract]:Objective: to investigate the clinical features of cholelithiasis complicated with primary colorectal cancer. Materials and methods: from November 2011 to December 2013, colorectal cancer was diagnosed by pathology in the first Hospital of Bethune, Jilin University, from November 2011 to December 2013. 65 patients with cholelithiasis were diagnosed by transabdominal CT or / and color Doppler ultrasonography, and 65 patients were not complicated with biliary system diseases. Age, sex, number of cancer foci, location, pathological type, degree of differentiation and stage were compared. SPSS17.0 statistical software was used to analyze the data. Results: 1. The ratio of male and female in cholelithiasis complicated with colorectal cancer group was lower than that in colorectal cancer group, but the difference was not statistically significant (P > 0.05). 2. In the group of cholelithiasis complicated with colorectal cancer, the proportion of 55 ~ 79 years old was the highest (75%), and the median age was 68 years old. The proportion of colorectal cancer patients aged 45 to 74 years old was the highest, accounting for more than 75%, the median age was 59 years old. The difference between the two groups was statistically significant (P < 0.01). There was a significant difference between the elderly patients with cholelithiasis complicated with colorectal cancer and the colorectal cancer patients (P < 0.01). 3. There were 4 cases of multiple primary carcinoma in cholelithiasis complicated with colorectal cancer group, and there was no significant difference compared with colorectal cancer group (P > 0.05). 4. Adenocarcinoma was the most common pathological type in patients with cholelithiasis complicated with colorectal cancer, followed by mucinous adenocarcinoma, which was similar to that in colorectal cancer group (P > 0.05). 5. There were 13 poorly differentiated lesions (18.84%) in the cholelithiasis complicated with colorectal cancer group, which was higher than 7.35 in the colorectal cancer group (P < 0.05). 6. The late stage of cholelithiasis complicated with colorectal cancer group was higher than that of colorectal cancer group, and there was significant difference between the two groups in stage 鈪

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