结直肠黏液腺癌与非黏液腺癌临床病理分析

Clinicopathological analysis of colorectal mucinous adenocarcinoma and nonmucinous adenocarcinoma

摘要:

目的  探讨结直肠黏液腺癌与非黏液腺癌临床病理特征及治疗预后的特点。方法  回顾性分析郑州大学第一附属医院从2009年1月-2013年6月收治的2 022例初治结直肠癌，将117例黏液腺癌与1 905例非黏液腺癌的临床病理资料进行比较。结果  相比于非黏液腺癌组患者，黏液腺癌组患者更年轻（<45岁占23.9%，P <0.05），术前CEA值更高（>5 ng/ml占42.7%，P <0.05），肿瘤平均直径更大（6.0 cm，P <0.05），更多位于右半结肠（47.9%，P <0.05），更高的病理T分期（T3、T4占91.5%，P <0.05）。结论  结直肠黏液腺癌发现时有更多处于晚期，且主要发生在右半结肠，预后差于非黏液腺癌。结直肠黏液腺癌需要更加有效的综合治疗方法。

Abstract:

Objective To investigate the clinicopathological characteristics and prognosis of colorectal mucinous adenocarcinoma (MAC) and non-MAC. Methods A retrospective study was performed on 2,022 newly-diagnosed patients with colorectal cancer from Jan. 2009 to Jun. 2013 in the First Affiliated Hospital of Zhengzhou University. Among them, 117 patients had MAC and 1,905 patients had non-MAC. Their clinicopathological characteristics were compared. Results Compared to the patients with non-MAC, those with MAC were younger (age < 45 years accounted for 23.9%, P < 0.05), and had higher preoperative carcinoembryonic antigen level (42.7% patients > 5 ng/ml, P < 0.05), larger average tumor diameter (6.0 cm, P < 0.05), more right hemicolon cancer (47.9%, P < 0.05), and higher pathologic T stage (T3 and T4 accounted for 91.5%, P < 0.05). Conclusions Compared to non-MAC, MAC has been found at more advanced stage, mainly locates at the right hemicolon and has poorer prognosis. MAC differs from non-MAC in biological behavior, so patients with MAC require more efficient comprehensive therapy.