蒲静刘苏（.上海市嘉定区南翔镇社区卫生服务中心 上海 20802；2.上海市闸北区中心医院 上海 200070）

结直肠癌155例分析

蒲静1刘苏2*
（1.上海市嘉定区南翔镇社区卫生服务中心 上海 201802；2.上海市闸北区中心医院 上海 200070）

摘 要目的：分析结直肠癌的临床变化特点，为临床诊治提供依据。方法：收集2009年10月-2013年1月经结肠镜病理确诊的结直肠癌患者155例，按年龄分为青年组（＜45岁）11例（7.1%）、中年组（45～60岁）43例（27.7%）和老年组（＞60岁）101例（65.2%），对患者的主要临床表现、肿瘤部位、病理学类型、临床病理分期进行回顾性分析。结果：所有患者均以便血及黏液便为主要临床症状，青年组、中年组和老年组腹痛、腹泻的发生率分别为18.2%和9.1%，34.9%和41.9%、34.7%和19.8%。老年组便秘、急性肠梗阻的发生率为24.8%，青年组无发生。三组患者的发病部位均以直肠为主，占34.8%（54/155）。三组肿瘤的病理学类型均以中分化腺癌最多，占60.0%（93/155），但青年组（45.5%）的低分化癌比例明显高于中年组（7.0%）和老年组（5.0%）。临床分期以中晚期为主，Dukes B、C、D期分别占17.4%、34.8%、34.8%，Dukes A期仅占9.0%。结论：结直肠癌患者仍以老年人为主，目前有年轻化趋势，病理类型主要为腺癌，绝大部分患者发病时已处于中晚期。

关键词结直肠癌 临床症状 病变部位 病理类型

Analysis of 155 patients with colorectal carcinoma

PU Jing1, LIU Su2
(1.Nanxiang Community Health Service Center of Jiading District, Shanghai 201802, China; 2. Zhabei District Central Hospital, Shanghai 200070, China)

ABSTRACTObjective: To analyze the clinical change feature of colorectal cancer to provide the clinical indications for its diagnosis and treatment. Methods: One hundred and fifty-five cases with colorectal cancer that were colonoscopicly and pathologically diagnosed from October 2009 to January 2013 were collected and classified according to their ages into the young group (<45 years old) 11 cases (7.1%), middle age group (45-60 years old) 43 cases (27.7%), and the old group (>60 years old) 101 cases (65.2%). Their main clinical manifestations, lesion location, pathological types and clinical pathologic staging were retrospectively analyzed. Results: The main clinical manifestations of all these patients were hematochezia and mucus stool. The abdominal pain and diarrhea occurrence rates in the young, middle aged and old patient groups were 18.2 and 9.1%, 34.9 and 41.9% and 34.7 and 19.8%, respectively. The incidence of the constipation and acute intestinal obstruction in the old patient group was 24.8% and none in the young patient group. The lesion in the three groups were mainly in rectum, accounting for 34.8% (54/155). The type of tumor pathology in the three groups were the moderately differentiated adenocarcinoma, accounting for 60% (93/155), but the proportion of the low differentiation carcinoma in the young group (45.5%) was significantly higher than those in the middle age group (7%) and the elderly group (5%). The clinical staging was the advanced mainly. Dukes B, C, and D accounted for 17.4%, 34.8%, and 34.8%, respectively. Dukes A accounted for only 9%. Conclusion: The patients with colorectal cancer are mainly the elderly population, and There are currently a trend in favor of young people. The pathologic type is adenocarcinoma mainly. Most patients are already in advanced stage when the disease is diagnosed.

KEY WORDScolorectal cancer; clinical symptom; lesion; pathological type

结直肠癌在西方国家的发病率居恶性肿瘤的第2~3位[1]，全球每年约120万新发病例，死于结直肠癌的患者约60万[2]，随着国内居民生活水平的提高和饮食习惯的日益西方化，我国结直肠癌的发病率也逐年提高，城

市已达每年4.2%，且死亡率占全国恶性肿瘤的第5位[3]。

结直肠癌有多种致病因素，临床症状主要为便血、腹痛、腹泻、便秘、肠梗阻、消瘦、贫血等，但早期无明显症状；……