青年人结直肠癌临床特征分析

Clinical characteristics analysis of young patients with colorectal cancer

关键词:  结直肠癌  青年  临床特点

Key words:  colorectal cancer  young  clinical characteristics

摘要:

目的　通过比较不同年龄段结直肠癌患者的临床特征，了解青年人结直肠癌发病规律及特点。　方法　回顾性分析大连医科大学附属第二医院2004年12月至2014年9月经手术及病理确诊且病例资料完整的38例青年结直肠癌患者（年龄≤40岁）的临床资料，并随机抽取同期收治的中老年（年龄＞40岁）结直肠癌患者80例组成中老年组作为对照，对两组患者的临床特点进行比较分析，并比较青年组结肠癌与直肠癌的临床特点。　结果　青年组与中老年组结直肠癌患者在麻醉ASA分级、症状时间、误诊率、分化程度、肿瘤直径等方面差异有显著性意义（P＜0.05），而在性别、吸烟史、饮酒史、家族史、肠道腺瘤及息肉史、首发症状、发病部位、临床分期、术前CEA以及CA19-9等方面则差异无显著性意义（P＞0.05）。中老年组肿瘤直径明显小于青年组（P＜0.05)。青年结肠癌肿瘤直径大于青年直肠癌，差异有显著性意义（P＜0.05）。青年组结肠癌误诊率为37.5%，高于青年直肠癌的7.1%，但差异无显著性意义（P=0.059）。青年结肠癌患者症状时间小于青年直肠癌，差异有显著性意义（P＜0.01）。　结论　青年人结直肠癌确诊时间长、误诊率高、肿瘤类型相对复杂且分化程度低、肿瘤生长快，提示预后不良。

Abstract:

Objective To compare the characteristics of colorectal cancer in different age groups in order to fully understand the pathogenesis and characteristics of colorectal cancer in young patients. 　Methods We retrospectively analyzed the clinical data of 38 young patients who were under 40 with integrated information and diagnosed by surgical and pathological examination in the second affiliated hospital of Dalian medical university from December 2004 to September 2014. The data were compared with 80 cases of colorectal patients with age above 40 as a control group. 　Results Significant differences were found in ASA stage, symptom time, misdiagnosis rate, differentiation grade, and tumor diameter. There were no significant differences in gender, smoking history, drinking history, family history, intestinal adenoma and polyp history, initial symptoms, site, clinical stage, and preoperative CEA and CA19-9 levels. Tumor diameter in the control group was obviously lower than that in the young group （P＜0.05). Tumor diameter in patients with colon cancer was remarkably larger than that in patients with rectal cancer (P<0.05). Misdiagnosis rate of colon cancer in the young group was 37.5%, which was slightly higher than 7.1% of rectal cancer without a statistical significance (P=0.059). Time of symptoms in young colon cancer patients was obviously less than that in the young rectal cancer patients (P< 0.01). 　Conclusion The young colorectal cancer group has long diagnosis time, high misdiagnosis rate, relatively complex tumor type, poor differentiation and fast tumor growth, indicating a poor outcome.