|
Objective: To analyze the clinical data of 582 cases of colorectal cancer in 5 years, to explore Dalian colorectal clinical case features and the trend in recent years. Methods: 582 cases of colorectal cancer patients with pathologically proved retrospective survey of Dalian Medical University Second Affiliated Hospital between January 2002 to December 2006 5 years, the analysis of clinical cases characteristics, including age of onset, lesions, pathological type, clinical manifestations, comorbidities, prognosis and outcome, recurrence and metastasis, Dukes stage, tumor markers, immunohistochemistry indicators. Based on the colorectal diagnostic criteria postoperative histopathological examination. 582 patients were divided into different age groups, respectively lt; 29-year-old, 30 to 39 years old, 40 to 49 years old, 50 to 59 years, 60 to 69 years, 70 to 79-year-old gt; 80 years of age. According to pathological type, colorectal cancer is divided into four categories of adenocarcinoma (well-differentiated adenocarcinoma, moderately differentiated adenocarcinoma, poorly differentiated adenocarcinoma), mucinous adenocarcinoma, signet ring cell carcinoma and other types of cancer (carcinoid, squamous cell carcinoma) . Lesion of colorectal cancer is divided into the rectum, sigmoid colon, descending colon, splenic flexure, transverse colon, hepatic flexure, ascending colon, ileocecal; left colon sigmoid and descending colon, splenic flexure, right colon includes the transverse colon. hepatic flexure, ascending colon, ileocecal. Radioimmunoassay detection of serum CA19-9 and CEA immunohistochemical methods on 322 patients of nm23, Topo-II were detected. The normal distribution of measurement data is described as x ± s difference test between the two groups using t test, multiple comparison test using One-way ANOVA variance skewed distribution measurement data described M ± Q, the differences in rank sum test was used to compare ; x2 test count data using hierarchical data using non-parametric tests. Results: 1 Age: the average age of onset of 65 ± 19 years old, all ages 60 to 69 years old and 70 to 79-year-old colorectal cancer high incidence of age (P lt; 0.05); increase with age, well-differentiated adenocarcinoma constituent ratio showed a clear upward trend, poorly differentiated adenocarcinoma of the constituent ratio decreases significantly (P lt; 0.05). Lesion: the rectum up, accounting for 56.01%, rectum, colon lesion composition than 5 years, there was no significant change (P gt; 0.05). Pathological type: mainly adenocarcinoma, moderately differentiated adenocarcinoma, accounting for 58.22% of adenocarcinoma; constituted of poorly differentiated adenocarcinoma in five years than there is an upward trend, mucinous adenocarcinoma, a downward trend (P lt; 0.05 ). Clinical manifestations: change in bowel habits, blood in the stool, abdominal pain / abdominal discomfort is still the most common symptoms of colorectal cancer the stool symptoms are most common in the rectum, accounting for 73.79%. Concurrent polyps in 170 cases, including 64 cases of adenomatous polyps; adenoma rate descending order of villous adenoma, tubulovillous adenoma, tubular adenoma. Higher prevalence of diabetes, gallstone, chronic appendicitis and other diseases. 5, during the observation period 582 patients with colorectal cancer death of the 72 cases in which the shortest survival time of 10 days, up to 4.5 years. The cause of death up to advanced cancer of the respiratory and circulatory failure, cachexia. Time to relapse more common after 2 years, accounting for 75.00%; transfer survival period is generally for one year, accounted for 75.13% of the most common sites of metastases to the liver metastases. 6, the Dukes of colorectal cancer staging A period accounted for only 6.18%, B, C, D period (advanced cancer) accounted for 93.81 percent. In Dukes stage progress CEA gradually increased (P lt; 0.05). Immunohistochemical indicators nm23 and Topo-II colorectal cancer tissue differentiation, histological grade lower, the higher the intensity of expression of the two (P lt; 0.05). Conclusions: 1,582 cases of colorectal cancer data analysis, the high incidence of ages 60 to 79 years old, increases with age, well-differentiated adenocarcinoma constituent ratio increased, poorly differentiated adenocarcinoma constituent ratio decreased; five-year increase in poorly differentiated adenocarcinoma, mucous glands cancer decreased. 2, adenomatous colorectal precancerous lesions, the a villous adenoma highest rate. Diabetes, gall stones, chronic appendicitis may be related to colorectal cancer pathogenesis. 3, recurrence and metastasis is an important factor affecting the prognosis of colorectal cancer. CEA and Dukes stage progress is closely related with the progress of Dukes stage, CEA was significantly higher, and there is a close correlation with recurrence and metastasis. 4, nm23 and Topo-II is related to the degree of differentiation of the colorectal cancer tissue immunohistochemistry indicators.
|