中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
26期
1804-1807
,共4页
陈创奇%方乐堃%马晋平%蔡世荣%董文广%黄奕华%何裕隆%詹文华
陳創奇%方樂堃%馬晉平%蔡世榮%董文廣%黃奕華%何裕隆%詹文華
진창기%방악곤%마진평%채세영%동문엄%황혁화%하유륭%첨문화
结肠肿瘤%直肠肿瘤%预后%回归分析
結腸腫瘤%直腸腫瘤%預後%迴歸分析
결장종류%직장종류%예후%회귀분석
Colonic neoplasms%Rectal neoplasms%Prognosis%Regression analysis
目的 探讨广东地区结直肠癌的临床病理特点和影响预后的因素.方法 总结中山大学附属第一医院1995-2007年经病理确诊的2042例结直肠癌的临床资料,分析其临床特点和预后情况.结果 2042例患者的中位年龄为59岁,好发年龄为50~70岁.男女比例为1.4:1.直肠是最常见部位,占46.2%,其次为乙状结肠,占22.0%.年龄<40岁患者黏液癌占16.7%,而低分化癌占33.5%,比例明显高于40岁以上患者.根据TNM分期,Ⅰ期占5.8%,Ⅱ期占42.9%,Ⅲ期占31.0%,Ⅳ期占20.3%.结直肠癌总体生存率1年为92.3%,3年为73.9%,5年为65.1%,10年为57.5%.年龄、大体分型、分化程度、TNM分期和手术方式是影响结直肠癌患者生存的独立危险因素,辅助化疗是保护因素.1995-2001年(第Ⅰ阶段)与2002-2007年(第Ⅱ阶段)比较,第Ⅱ阶段中使用吻合器、直肠癌行Dixon手术和化疗的比例增高,第Ⅱ阶段1、3、5年生存率分别为93.4%、78.0%、73.2%,明显高于第Ⅰ阶段(90.6%、69.2%、58.8%).结论 年龄、大体分型、分化程度、TNM分期、手术方式和辅助化疗是影响结直肠癌患者生存的重要因素.
目的 探討廣東地區結直腸癌的臨床病理特點和影響預後的因素.方法 總結中山大學附屬第一醫院1995-2007年經病理確診的2042例結直腸癌的臨床資料,分析其臨床特點和預後情況.結果 2042例患者的中位年齡為59歲,好髮年齡為50~70歲.男女比例為1.4:1.直腸是最常見部位,佔46.2%,其次為乙狀結腸,佔22.0%.年齡<40歲患者黏液癌佔16.7%,而低分化癌佔33.5%,比例明顯高于40歲以上患者.根據TNM分期,Ⅰ期佔5.8%,Ⅱ期佔42.9%,Ⅲ期佔31.0%,Ⅳ期佔20.3%.結直腸癌總體生存率1年為92.3%,3年為73.9%,5年為65.1%,10年為57.5%.年齡、大體分型、分化程度、TNM分期和手術方式是影響結直腸癌患者生存的獨立危險因素,輔助化療是保護因素.1995-2001年(第Ⅰ階段)與2002-2007年(第Ⅱ階段)比較,第Ⅱ階段中使用吻閤器、直腸癌行Dixon手術和化療的比例增高,第Ⅱ階段1、3、5年生存率分彆為93.4%、78.0%、73.2%,明顯高于第Ⅰ階段(90.6%、69.2%、58.8%).結論 年齡、大體分型、分化程度、TNM分期、手術方式和輔助化療是影響結直腸癌患者生存的重要因素.
목적 탐토엄동지구결직장암적림상병리특점화영향예후적인소.방법 총결중산대학부속제일의원1995-2007년경병리학진적2042례결직장암적림상자료,분석기림상특점화예후정황.결과 2042례환자적중위년령위59세,호발년령위50~70세.남녀비례위1.4:1.직장시최상견부위,점46.2%,기차위을상결장,점22.0%.년령<40세환자점액암점16.7%,이저분화암점33.5%,비례명현고우40세이상환자.근거TNM분기,Ⅰ기점5.8%,Ⅱ기점42.9%,Ⅲ기점31.0%,Ⅳ기점20.3%.결직장암총체생존솔1년위92.3%,3년위73.9%,5년위65.1%,10년위57.5%.년령、대체분형、분화정도、TNM분기화수술방식시영향결직장암환자생존적독립위험인소,보조화료시보호인소.1995-2001년(제Ⅰ계단)여2002-2007년(제Ⅱ계단)비교,제Ⅱ계단중사용문합기、직장암행Dixon수술화화료적비례증고,제Ⅱ계단1、3、5년생존솔분별위93.4%、78.0%、73.2%,명현고우제Ⅰ계단(90.6%、69.2%、58.8%).결론 년령、대체분형、분화정도、TNM분기、수술방식화보조화료시영향결직장암환자생존적중요인소.
Objective To explore the clinical characteristics and the prognostic factors of patients with colorectal cancer. Methods The data of 2042 cases of colorectal cancer, pathologically confirmed at our hospital from January 1995 to December 2007, were summarized and analyzed. Results The median age of all cases with colorectal cancer was 59 years old. The high-risk age ranged from 50 to 70 years old. The ratio of male and female was 1.4: 1. The lesions located in rectum accounted for 46.2% and those for 22.0% in sigmoid. Patients under age 40 had a higher percentage of poor differentiation (33.5%) and mucinous carcinoma(16.7%).The cases with confirmed stage Ⅰ,Ⅱ,ⅢandⅣwere 5.8%,42.9%,31.0%and 20.3%respectively.For all cases,the 1-,3-,5-and 10-year sunrvival rates were 92.3%,73.9%.65.1%and 57.5%respectively.The independent risk factors for patient prognosis were age,gross type,differentiation,TNM staging and surgical type.Adjuvant chemotherapy was a protective factor.As compared with phase Ⅰ(1995-2001),phaseⅡ(2002-2007)had a higher pmportions of employing stapler,Dixon operation and adjuvant chemotherapy.The 1-,3-and 5-year survival rates of phase Ⅱ were higher than phase Ⅰ(93.4%,78.0%and 73.2%vs 90.6%,69.2%and 58.8%).Conedusion The prognostic factors of patients with colorectal cancer are age, gross type, differentiation, TNM staging, surgical type and adjuvant chemotherapy.