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目的研究结直肠同时性多发癌发病特点及临床病理特征,探讨其早期诊断措施。方法回顾性分析1994年6月至2003年12月中山大学附属第一医院根治性手术治疗的1225例结直肠癌患者资料,根据癌灶数目、家族史、发病年龄等情况分为结直肠同时性多原发癌组(多发组)和结直肠单发癌组(单发组)。比较两组发病年龄、性别构成、肿瘤Dukes分期、肿瘤部位、并发息肉和患者预后等情况。所有资料采用SPSS 10．0软件统计分析。结果多发组39例(3．2％),其中2例为遗传性非息肉病性结直肠癌患者,并发癌以腺瘤恶变多见。多发组中右半结肠癌占45．7％,明显高于单发组22．7％(x2=25．757,P=0．0001);息肉并发率两组分别为33．3％和16％(x2=6．787, P=0．009)。异时性肿瘤发生率分别为5．1％和1．2％,差异有统计学意义(x2=4．545,P=0．033)。多发组5年生存率为57％,单发组为64％,x2=0．084,P=0．772。结论结直肠同时性多发癌占结直肠癌总数的3．2％,多位于右半结肠,并发癌以腺瘤恶变多见,其预后与单发癌患者相当。
Objective To study the characteristics and clinicopathological features of concurrent colorectal carcinogenesis and to discuss its early diagnosis. Methods The data of 1225 colorectal cancer patients who underwent radical surgery in the First Affiliated Hospital of Sun Yat-sen University from June 1994 to December 2003 were retrospectively analyzed. According to the number of cancer, family history and age of onset, the data were divided into colorectal simultaneity Multiple primary cancers (multiple episodes) and colorectal single carcinomas (single episodes). The age of onset, gender, tumor stage, tumor location, polyps and prognosis were compared between the two groups. All data using SPSS 10.0 software statistical analysis. Results Multiple group of 39 patients (3.2%), of which 2 cases of hereditary non-polyposis colorectal cancer patients with adenocarcinoma complicated with cancer more common. The incidence of right colon cancer in multiple group was 45.7%, significantly higher than that in single group (x2 = 25.757, P = 0.0001). The incidence of polyps was 33.3% and 16 % (X2 = 6.787, P = 0.009). The incidence of metachronous tumors were 5.1% and 1.2%, respectively, with significant differences (x2 = 4.545, P = 0.033). The 5-year survival rate was 57% in the multiple group and 64% in the single group, x2 = 0.084, P = 0.772. Conclusions Multiple colorectal carcinomatous carcinomas account for 3.2% of the total number of colorectal cancer. Most of them are located in the right colon, while malignant adenocarcinoma is more common in patients with colorectal cancer. The prognosis is comparable to that of single cancer patients.