中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2009年
5期
380-383
,共4页
徐海涛%于志伟%邢军%董新舒
徐海濤%于誌偉%邢軍%董新舒
서해도%우지위%형군%동신서
肠肿瘤%大体分型
腸腫瘤%大體分型
장종류%대체분형
Colorectal cancer%Classification,macroscopic
目的 探讨简化大肠癌大体分型的可行性和临床意义.方法 回顾性分析1379例有完整随访记录的大肠癌患者的临床资料,所有患者按照大体类型分组:1组为隆起型,2组为限局溃疡型,3组为浸润性,4组为浸润溃疡型;简化分型后,A组为限局型,B组为浸润型.比较原大体分型和简化大体分型与大肠癌组织学类型、肠肇浸润深度、淋巴结转移程度、淋巴结转移数量之间的关系以及对患者生存期的影响.结果 在低级别大肠癌比例、大肠癌浸润深度、淋巴结转移程度、淋巴结转移数量和5年生存率等指标上,1组和2组、3组和4组之间的差异均尢统计学意义(均P>0.05);而3、4组的上述指标分别与1、2组相比,差异有统计学的意义(均P<0.05),即浸润型和浸润溃疡型癌的组织学分化程度更差、肠壁浸润更深、淋巴结转移更严重.简化分型后,A、B两组的组织学分化程度、肠壁浸润深度、淋巴结转移程度、淋巴结转移数量和5年生存率的差异均有统计学意义(均P<0.05).结论 原大肠癌大体分型中,隆起型和限局溃疡型、浸润型和浸润溃疡型的临床病理学特征相似,可以通过分别合并达到简化大体分型的目的 .简化大体分型在临床医生对大肠癌的诊断治疗和预后判断中均有莺要的指导意义.
目的 探討簡化大腸癌大體分型的可行性和臨床意義.方法 迴顧性分析1379例有完整隨訪記錄的大腸癌患者的臨床資料,所有患者按照大體類型分組:1組為隆起型,2組為限跼潰瘍型,3組為浸潤性,4組為浸潤潰瘍型;簡化分型後,A組為限跼型,B組為浸潤型.比較原大體分型和簡化大體分型與大腸癌組織學類型、腸肇浸潤深度、淋巴結轉移程度、淋巴結轉移數量之間的關繫以及對患者生存期的影響.結果 在低級彆大腸癌比例、大腸癌浸潤深度、淋巴結轉移程度、淋巴結轉移數量和5年生存率等指標上,1組和2組、3組和4組之間的差異均尢統計學意義(均P>0.05);而3、4組的上述指標分彆與1、2組相比,差異有統計學的意義(均P<0.05),即浸潤型和浸潤潰瘍型癌的組織學分化程度更差、腸壁浸潤更深、淋巴結轉移更嚴重.簡化分型後,A、B兩組的組織學分化程度、腸壁浸潤深度、淋巴結轉移程度、淋巴結轉移數量和5年生存率的差異均有統計學意義(均P<0.05).結論 原大腸癌大體分型中,隆起型和限跼潰瘍型、浸潤型和浸潤潰瘍型的臨床病理學特徵相似,可以通過分彆閤併達到簡化大體分型的目的 .簡化大體分型在臨床醫生對大腸癌的診斷治療和預後判斷中均有鶯要的指導意義.
목적 탐토간화대장암대체분형적가행성화림상의의.방법 회고성분석1379례유완정수방기록적대장암환자적림상자료,소유환자안조대체류형분조:1조위륭기형,2조위한국궤양형,3조위침윤성,4조위침윤궤양형;간화분형후,A조위한국형,B조위침윤형.비교원대체분형화간화대체분형여대장암조직학류형、장조침윤심도、림파결전이정도、림파결전이수량지간적관계이급대환자생존기적영향.결과 재저급별대장암비례、대장암침윤심도、림파결전이정도、림파결전이수량화5년생존솔등지표상,1조화2조、3조화4조지간적차이균왕통계학의의(균P>0.05);이3、4조적상술지표분별여1、2조상비,차이유통계학적의의(균P<0.05),즉침윤형화침윤궤양형암적조직학분화정도경차、장벽침윤경심、림파결전이경엄중.간화분형후,A、B량조적조직학분화정도、장벽침윤심도、림파결전이정도、림파결전이수량화5년생존솔적차이균유통계학의의(균P<0.05).결론 원대장암대체분형중,륭기형화한국궤양형、침윤형화침윤궤양형적림상병이학특정상사,가이통과분별합병체도간화대체분형적목적 .간화대체분형재림상의생대대장암적진단치료화예후판단중균유앵요적지도의의.
Objective To explore the feasibility and clinical significance of a modified macroscopic classification of colorectal cancer. Methods The data of 1379 patients with eolorectal cancer surgically treated between 1975 and 2003 were retrospectively analyzed. The patients were divided into four groups according to the primary macroscopic appearance: protruding type (group 1), local ulcerative type (group 2), invasive type (group 3) and non-invasive ulcerative type (group 4). The new classification system was simplified into two types: non-invasive type (group A, including group 1 and 2) and invasive type (group B, including group 3 and 4). The histo-differentiation, invasive depth into the intestinal wall, distance and number of lymph node metastasis and 5-year survival rate were analyzed and compared among the groups. Results There was no significant difference between group 1 and 2, and between group 3 and 4 in histo-differentiation, invasive depth into the intestinal wall, distance and number of lymph node metastasis and 5-year survival rate (P > 0.05). However, after modification of the primary macroscopic classification, a significant difference was observed in all the above mentioned parameters between group A and group B (P < 0.05). Conclusion Our results demonstrate that the clinicopathological characteristics of the group 1 and 2, and of the group 3 and 4 are similar to each other. So it is reasonable to merge the protruding type and local ulcerative type into non-invasive type, while invasive type and non-invasive ulcerative type into invasive type. This simplified macroscopic classification should be practical and instructive in diagnosis, treatment and prognosis of colorectal cancer.
