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目的探讨青年人(年龄≤30岁)结直肠癌的临床病理特征及预后。方法年龄≤30岁的结直肠癌患者共283例,回顾性总结并分析其临床及随访资料。结果283例青年结直肠癌患者中,临床表现以黏液血便(71.4%)、大便习惯改变(63.6%)最为常见,全组误诊率31.7%,肿瘤部位以直肠(57.2%)最多,其次是乙状结肠(15.8%),恶性度高的低分化腺癌、黏液腺癌、印戒细胞癌和未分化癌共占50.4%,TNM分期:Ⅰ期11.0%,Ⅱ期23.2%,Ⅲ期29.5%,Ⅳ期36.3%,5年生存率:Ⅰ期79%,Ⅱ期71%,Ⅲ期44%,Ⅳ期6%,5年、10年生存率分别为38%和35%。结论青年人结直肠癌误诊率高,恶性度高的病理类型比例高,分期晚,预后差。
Objective To investigate the clinicopathological features and prognosis of young patients (≤30 years old) with colorectal cancer. Methods A total of 283 colorectal cancer patients aged ≤30 years were retrospectively reviewed and analyzed for clinical and follow-up data. Results Among the 283 young patients with colorectal cancer, the clinical manifestations were mucous bloody stool (71.4%) and change of bowel habits (63.6%), the rate of misdiagnosis was 31.7% in the whole group, the rectum (57.2%) was the largest, followed by the sigmoid colon (15.8%), poorly differentiated adenocarcinoma, mucinous adenocarcinoma, signet-ring cell carcinoma and undifferentiated carcinoma accounted for 50.4%. The TNM stage was 11.0% in stage I, 23.2% in stage II and 29.5% in stage III The 36-year survival rate was 36.3%. The 5-year survival rate was 79% in stage I, 71% in stage II, 44% in stage III, 6% in stage IV, and 38% and 35% in 5-year and 10-year respectively. Conclusions The misdiagnosis rate of colorectal cancer in young people is high, the proportion of pathological types with high malignant degree is high, the stage is late, and the prognosis is poor.