277例左右半结肠癌临床表现、病理类型及生存预后的比较分析

发布时间：2018-11-24 10:17

【摘要】：目的收集我科近年来收治的左半结肠癌与右半结肠癌患者的临床表现、病理类型、生存预后等方面的资料,研究分析两者在流行病学特征、临床表现、病理类型及其生存预后方面的差异,为临床精准化、个体化地制定不同部位的结肠癌治疗策略及发病机制研究提供奠定基础。方法回顾性分析吉林大学附属中日联医院2014年10月1日至2017年1月31日间住院治疗的结肠癌患者277例(右半结肠癌128例,左半结肠癌149例)。采取调阅患者病历资料及随访调查方式收集患者的年龄、性别、临床症状、病理特征、治疗方式等信息,并通过电话随访掌握患者的预后生存情况。采集数据后统一进行整理分析,根据结肠癌病发病部位的不同把全部患者分为左半结肠癌组与右半结肠癌组。分别对两组的数据进行统计分析,构成比差别采用c2检验,并且使用Kaplan-Meier绘制生存曲线,生存时间比较使用Log-rank分析,p0.05有显著统计学差异。结果1、有277例结肠癌患者入组。其中,右半结肠癌患者为128例,占比46.21%,左半结肠癌患者为149例,占比53.78%。男性患者中左半结肠癌比例较高,而女性患者中右半结肠癌比例相对较高,差异有统计学意义(p0.05)。2、分别统计比较左右半结肠癌患者在不同年龄段的分布,两组存在显著差异,P0.05,右半结肠癌发病年龄较晚。3、右半结肠癌患者主要临床症状为腹痛、腹胀、腹泻,腹部可扪及明显包块,而左半结肠癌患者主要临床症状则包括血便、大便性状及排便习惯改变为主要表现,两组首发症状有显著差异,P0.05,具有统计学意义。4、右半结肠癌肿瘤体积较左侧更大,而病理分型多以中、低分化为主,淋巴转移较多见,P0.05。而两者在远处转移方面未见显著差异,P0.05。5、右半结肠癌确诊时病理分析相对较晚,右半、左半Ⅲ、Ⅳ期总共占比51.56%VS 29.56%。两组比较存在显著差异,P0.05。6、左右半结肠癌Ⅰ、Ⅱ期预后相似,P0.05,Ⅲ、Ⅳ期预后较左半结肠癌差,P0.05。结论1、有277例结肠癌患者入组。其中,右半结肠癌患者为128例,占比46.21%,左半结肠癌患者为149例,占比53.78%。男性患者中左半结肠癌比例较高,而女性结肠癌患者中右半结肠癌占比较高。2、对搜集病例中患者的年龄分析结果显示,右半结肠癌肿瘤发病年龄较左侧晚。3、右半结肠癌患者主要临床表现为腹痛、腹胀、腹泻,腹部可扪及明显包块。而左半结肠癌患者多以血便、大便性状及排便习惯改变为主要临床表现。4、右半结肠癌肿瘤体积较左侧更大,而病理分型多以中、低分化为主,淋巴转移较多见。而两者在远处转移方面未见显著差异。5、右半结肠癌TNM分期较晚,左半结肠癌发病时TNM分期更早。6、左右半结肠癌Ⅰ、Ⅱ期预后相似,右半结肠癌Ⅲ、Ⅳ期预后较左半结肠癌短。
[Abstract]:Objective to collect the clinical manifestations, pathological types, survival and prognosis of patients with left and right colon cancer treated in our department in recent years, and to study and analyze their epidemiological characteristics and clinical manifestations. The differences in pathological types and survival and prognosis lay a foundation for clinical precision and individualized study on the therapeutic strategies and pathogenesis of colon cancer in different parts. Methods 277 patients with colon cancer (128 right colon cancer and 149 left colon cancer) who were hospitalized from October 1, 2014 to January 31, 2017 in Sino-Japanese Union Hospital affiliated to Jilin University were retrospectively analyzed. The patient's age, sex, clinical symptoms, pathological features and treatment methods were collected by reading the patient's medical records and follow-up investigation, and the prognosis and survival of the patients were obtained by telephone follow-up. After collecting data, the patients were divided into left colon cancer group and right colon cancer group according to the location of colon cancer. The two groups of data were statistically analyzed, the difference of constitution ratio was measured by c2 test, and the survival curve was drawn by Kaplan-Meier, and the survival time was compared by Log-rank analysis. There was significant difference between the two groups (p0.05). Results 1. 277 patients with colon cancer were enrolled. There were 128 patients with right colon cancer (46.21) and 149 patients with left half colon cancer (53.78%). The proportion of left colon cancer in male patients was higher than that in female patients, the difference was statistically significant (p0.05). 2. The distribution of left and right colon cancer patients in different age groups was compared. There was significant difference between the two groups, P0.05, the age of onset of right hemicolon was late. The main clinical symptoms of patients with right hemicolon were abdominal pain, abdominal distension, diarrhea, palpable abdominal mass. The main clinical symptoms of patients with left hemicolon cancer included blood stool, defecation traits and defecation habits. There was a significant difference between the first symptoms of the two groups (P0.05, with statistical significance. 4) The tumor size of the right colon cancer was larger than that of the left, while the pathological classification was mainly middle and low differentiation, and lymphatic metastasis was more common (P0.05. 0. 05). However, there was no significant difference in distant metastasis between the two groups (P0.05.5). The pathological analysis of right hemicolon carcinoma was relatively late. The ratio of 51.56%VS 29.5656 in stage 鈪，

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