结直肠癌患者临床资料的对比分析

Retrospective analysis of clinical data of patients with colorectal cancer in a hospital of Qiqihar city

摘要:

目的 掌握结直肠癌的发病情况及相关影响因素，寻找结直肠癌的发病规律，为今后结直肠癌的预防、筛查、诊治和预后等提供参考依据。方法 选取2008 年1 月-2014 年12 月在齐齐哈尔市第一医院行手术治疗的结直肠癌患者620 例为调查对象。收集患者的临床资料进行回顾性分析（包括患者人口学特征、临床症状、病理组织学分型、肿瘤部位及分化程度等），利用EpiData3.0 软件建立数据库，运用SPSS20.0 软件进行统计分析。结果 结直肠癌患者中，男性368 例（59.4%），女性252 例（40.6%）；结直肠癌中直肠癌287例（46.3%），结肠癌333 例（53.7%）。首发症状以腹痛、黑便和腹胀为主；便常规潜血指标阳性者300 例（48.4%），阴性者320 例（51.6%）。肿瘤标志物指标CEA 阳性者375 例（57.6%），阴性者263 例（42.4%）。CA199 阳性者197 例（31.8%），阴性者423 例（68.2%）；结直肠癌患者中，腺癌563 例（90.8%），黏液癌52 例（8.4%），印戒细胞癌3 例（0.5%），未分化癌2 例（0.3%）。Dukes 分期A 期230 例（37.1%），B 期130 例（21.0%），C期186 例（30.0%），D 期74 例（11.9%）。结论 通过对结直肠癌患者的人口学特征、临床表现及病理特点等方面进行探讨分析，为结直肠癌诊治及预后提供参考依据，应加强对高危人群进行筛查，做到早发现、早诊断、早治疗，提高患者的生存率和生活质量。

Abstract:

Objective To investigate the incidence and related factors of colorectal cancer, discuss the pathogenesis of colorectal cancer so as to provide reference for prevention, screening, diagnosis, treatment and prognosis assessment of colorectal cancer Methods A total of 620 cases of colorectal cancer patients who underwent surgical treatment in the First Hospital of Qiqihar from January 2008 to December 2014 were selected. The clinical data of the patients were collected and retrospectively analyzed which included patients’ demographic characteristics,clinical symptoms, tumor location, pathological type, and degree of differentiation, Dukes staging and laboratory tests, etc. Using EpiData 3.0 software data base was established, using SPSS 20.0 software the data were statistically analyzed. Results In the patients with colorectal cancer, there were 368 males (59.4%) and 252 women (40.6%). Rectal cancer occurred in 287 patients which accounted for 46.3%, and colon cancer occurred in 333 patients accounting for 53.7%. The initial symptoms of the patients were abdominal pain, melena and abdominal distension.of the patients with colorectal cancer, 300 cases had positive fecal occult blood, accounting for 48.4%; 320 cases had negative fecal occult blood (51.6%). Tumor marker CEA was positive in 357 cases which accounted for 57.6% and negative in 263 cases (42.4%); CA199 was positive in 197 cases (31.8%) and negative in 423 cases (68.2%).In the patients with colorectal cancer, there were 563 cases of adenocarcinomas (90.8%), 52 cases of mucinous carcinoma (8.4%), 3 cases of signet-ring cell carcinoma (0.5%), and 2 cases of undifferentiated carcinoma (0.3%).In the patients with colorectal cancer, 230 were in Dukes stage A (37.1%), 130 in Dukes stage B (21.0%), 186 in Dukes stage C (30.0%), and 74 in Dukes stage D (11.9%). Conclusions The analytical results of demographic characteristics, clinical symptoms and pathological characteristics of colorectal carcinoma can provide reference for the diagnosis and treatment of colorectal cancer. We should strengthen the screening of high-risk people, early detection, early diagnosis and early treatment, so as to improve the survival rate and the quality of life of the patients.