摘要
目的:分析青年人大肠癌的临床特点。方法:回顾性了解1990～2002年12年间本院住院的大肠癌患者,选择年龄≤40岁青年人57例,及年龄≥60岁中老年人57例,分析两组临床、病理等特征。结果:12年共有1332例大肠癌住院患者,其中年龄≤40岁青年大肠癌100例,占同期大肠癌检出率的7.51％;青年组就诊时间中位数2月,确诊时间中位数为4月,与中老年组无显著性差异(P>0.05)。青年组有癌家族史者10例(17.5％),显著多于中老年组(5.3％,P<0.05)。两组临床表现均以便血或粘液血便、腹痛为主要表现,发病部位均以直肠癌为多。青年组中粘液癌(粘液腺癌和印戒细胞癌)的发生率为40.4％,显著高于老年组(8.80%,P<0.005),青年组低分化癌占17.5％,显著多于中老年组低分化癌比例5.3％(P<0.05),肿瘤Dukes分期:青年组:A期1例,B期23例,C期24例,D期9例。青年组共误诊21例,误诊率为36.8％,显著高于中老年组的误诊率5.3％(P<0.001)。结论:大肠癌青年人占有一定比例,有癌家族史者易发生大肠癌,主要临床表现为便血或粘液血便、腹痛等,发病部位以直肠癌最常见,较老年人多误诊;病理以粘液癌、低分化癌较老年患者多见,早期诊断率低。
Objective:To study the clinicopathological features of colorectai cancer patients less than 40 years of age. Methods: To study retrospectively the in-patients with colorectai cancer in 12 years during Of 1990 to 2000. Comparing the clinicopathological representation of 57 patients less than 40 years age(young group) and 57 patients older than 60 years age(old group) .Results: There were total 1332 in-patients with colorectai cancer in 12 years, included 100 patients(7.5l%) were less than 40 years. The median time of hospitalizing and being diagnosed were 2 mothes and 4 monthes in young group respectivly, there were no significantly difference with the old group(P>0.05).There were lOcases (17.5%) with family cancer history in young group, which were higher significantly than the rate (5.3%)of the old group(P<0.05).The main clinic manifestations were blood stool or nucus blood stool and bellyache in both groups and rectum were the most frequent position of cancer in both groups. There were 23 cases (40.4%) were signet ring cell cancer and 10 cases (17.5%) in loewer differentiation in young group , which were higher significantly than the rates (8.8%, 5.3%) in the old gtoup(P<0.005, P<0.05). The stage by Dukes in young group were 1 case in A stage, 23 cases in B stage,24 cases in C stage and 9 cases in D stage. 21 cases were misdiagnosed in young group which were higher significantly than the rate (5.3%)in the old group (P<0.05). Conclusion: There are near 10% patient with colorectai cancer are less than 40 years age. Young adult with cancer family history are more incidental to suffer from colorectai cancer. The main clinic manifestations of young patients with colorectai cancer are blood stool and bellyache and rectum are the most frequent position to arises cancer.Misdiagnosis are frequent in young patients. Signet ring cell cancer are the most fequent pathologic manifestation and early cancer are seldom be diagnosed.
出处
《中国医药导刊》
2004年第1期17-19,共3页
Chinese Journal of Medicinal Guide
