同时性多原发性结直肠癌临床分析

发布时间：2018-11-10 13:12

【摘要】：目的:探讨同时性多原发性结直肠癌(Synchronous Colorectal Carcinoma,SCC)的临床发病特点、病理分期分型、手术治疗、预后及术后随访,以提高临床医师对于同时性多原发性结直肠癌的认识。方法:回顾分析自2012年1月至2016年12月皖南医学院第一附属医院普外科所有科室收治的经术后病理确诊的748例结直肠手术患者,剔除8例家族性结肠腺瘤病(Familial Adenomatous Polyposi,FAP)患者,剩余740例结直肠癌患者,对这些患者按照登记的身份证号码筛选出14例SCC患者进行分析。以性别、年龄、病灶分布、病理分型、临床分期、生存率等参数与同一时期726例单发性结直肠癌患者进行对比分析,用SPSS13.0统计学软件处理相关数据。结果:本研究14例同时性多原发性结直肠癌患者中,男性13例,女性1例,男女比例为13:1;发病年龄在43-87岁之间,平均年龄61.6岁。共发现癌灶30处,升结肠发病率26.7%,横结肠发病率16.7%,降结肠发病率13.3%,乙状结肠发病率23.3%,直肠发病率20.0%,同时性多原发性结直肠癌的发病率1.89%。除1例并发转移癌患者行姑息性手术,其余患者均行根治术,术后病理类型以腺癌多见83.3%,少数合并有粘液腺癌10.0%;术后对所有患者进行随访,其1,3,5年生存率分别为64.3%,28.6%,7.1%。结论:SCC患者好发年龄在60岁左右,男性发病患者较女性多,好发部位以升结肠、乙状结肠及直肠多见,有手术指征患者的手术方案需要结合肿瘤相关特点综合考虑。
[Abstract]:Objective: to investigate the clinical features, pathological staging, surgical treatment, prognosis and postoperative follow-up of simultaneous multiple primary colorectal cancer (Synchronous Colorectal Carcinoma,SCC) in order to improve clinicians' understanding of concurrent multiple primary colorectal cancer. Methods: from January 2012 to December 2016, 748 patients with colorectal surgery were treated in all departments of General surgery, first affiliated Hospital of Southern Anhui Medical College, and 8 patients with familial colonic adenomatosis (Familial Adenomatous Polyposi,) were removed. FAP), the remaining 740 patients with colorectal cancer, 14 patients with SCC were screened according to the registered ID number. Sex, age, lesion distribution, pathological classification, clinical stage, survival rate and other parameters were compared with 726 patients with single colorectal cancer in the same period. The data were analyzed by SPSS13.0 software. Results: in this study, there were 13 males and 1 female, the ratio of male to female was 13: 1, and the onset age was between 43 and 87 years, with an average age of 61.6 years. A total of 30 cancer foci were found, the incidence of ascending colon was 26.7cm, the incidence of transverse colon was 16.7, the incidence of descending colon was 13.3, the incidence of sigmoid colon was 23.3m, and the incidence of rectum was 20.0. The incidence of concurrent multiple primary colorectal cancer is 1.89. Palliative operation was performed in one patient with metastatic carcinoma, radical resection was performed in all the patients, the pathological type was 83.3% in adenocarcinoma and 10.0 in a few cases with mucinous adenocarcinoma. All the patients were followed up after operation. The survival rates of 1 and 5 years were 64.3% and 28.6%, respectively. Conclusion: the predilection age of SCC patients is about 60 years old, the incidence of male patients is more than that of women, and the most common sites are ascending colon, sigmoid colon and rectum. The operative plan of patients with surgical indications should be considered in combination with tumor-related characteristics.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34

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