CAJ | 학술논문

　　目的探讨结直肠粘液腺癌的临床病理特征及对预后的影响。方法选取2002年4月-2007年11月行外科切除的775例结直肠癌患者的临床病理资料。将患者分为两组：非粘液腺癌组（n=690）和粘液腺癌组（n=85）；比较两组患者的临床病理特征，分析两组患者及不同组织分化程度患者的术后生存率，探索影响预后的因素。结果全组病例粘液腺癌占结直肠癌的11.0%。两组患者在性别、远处转移、术前肠梗阻和手术方式方面比较，差异无统计学意义（P＞0.05）。粘液腺癌好发于右半结肠及青壮年，浸润型比例高，瘤体大，浸润深，容易发生淋巴结转移及TNM分期晚；术后总生存率比非粘液腺癌、高-中分化腺癌差；与低分化腺癌相比无明显差别。COX回归分析显示TNM分期、手术方式及组织分化程度为影响预后的独立因素。其中TNM分期是最危险的影响因素。结论结直肠粘液腺癌具有不良临床病理特征，其预后比非粘液腺癌、高-中分化腺癌差，与低分化腺癌相近，是预后的独立影响因素。
　　목적탐토결직장점액선암적림상병리특정급대예후적영향。방법선취2002년4월-2007년11월행외과절제적775례결직장암환자적림상병리자료。장환자분위량조：비점액선암조（n=690）화점액선암조（n=85）；비교량조환자적림상병리특정，분석량조환자급불동조직분화정도환자적술후생존솔，탐색영향예후적인소。결과전조병례점액선암점결직장암적11.0%。량조환자재성별、원처전이、술전장경조화수술방식방면비교，차이무통계학의의（P＞0.05）。점액선암호발우우반결장급청장년，침윤형비례고，류체대，침윤심，용역발생림파결전이급TNM분기만；술후총생존솔비비점액선암、고-중분화선암차；여저분화선암상비무명현차별。COX회귀분석현시TNM분기、수술방식급조직분화정도위영향예후적독립인소。기중TNM분기시최위험적영향인소。결론결직장점액선암구유불량림상병리특정，기예후비비점액선암、고-중분화선암차，여저분화선암상근，시예후적독립영향인소。
Objective To investigate the clinicopathological characteristics and prognosis of colorectal mucinous adenocarcinoma(MAC). Methods The clinicopathological data of 775 patients who underwent surgical resections from Apr. 2002 to Nov. 2007 in the department were collected. They were divided into two groups: MAC group(n=690)and non- MAC group(n=85). The clinicopathological characteristics were compared. Survival rates of the two groups and different degrees of histological differentiation were analyzed. Prognostic factors were researched. Results A rate of patients with MAC was 11.0%. It showed that characteristics such as gender, distant metastasis, preoperative intestinal obstruction and surgical modality had no significant difference between the two groups. MAC significantly showed higher frequencies of right-sided colon involvement, younger age, more infltrative type, large tumor size, lymphatic metastasis, advanced tumor invasion and advanced TNM stage than non-MAC. MAC had a poorer prognosis than those of non-MAC and well-moderately differentiated adenocarcinoma, but not that of low differentiated adenocarcinoma. COX regression analysis indicated TNM stage, surgical modality and histological differentiation were independent prognostic factors. The most hazardous factor was TNM stage.Conclusion Colorectal MAC has adverse clinicopathological characteristics, and a poor prognosis which is similar to low differentiated adenocarcinoma.It is also an independent prognostic factor .