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中华结直肠疾病电子杂志

中华结直肠疾病电子杂志 ›› 2013, Vol. 02 ›› Issue (04) : 162 -165. doi: 10.3877/cma.j.issn.2095-3224.2013.04.04.

所属专题： 经典病例； 文献；

论著

1810例左、右半结肠癌临床病理分析
陈伟1, 王贵玉1, 陈瑛罡1, 姜争1, 刘正1, 王猛1, 王洪伟1, 徐永鹏1, 王锡山1,†()   
  1. 1. 150086　哈尔滨医科大学附属第二医院结直肠肿瘤外科　哈尔滨医科大学大肠癌研究所
  • 收稿日期:2013-03-26 出版日期:2013-08-25
  • 通信作者: 王锡山

Statistical analysis of clinicopathologic characteristics of 1810 cases between right-and left-sided colon cancer.

Wei CHEN1, Gui-yu WANG1, Ying-gang CHEN1, Zheng JIANG1, Zheng LIU1, Meng WANG1, Hong-wei WANG1, Yong-peng XU1, Xi-shan WANG1,†()   

  1. 1. Department of Colorectal Surgery, the Second Affiliated Hospital, Harbin Medical University, Harbin 150086, China
  • Received:2013-03-26 Published:2013-08-25
  • Corresponding author: Xi-shan WANG
  • About author:
    Corresponding author: WANG Xi-Shan, Email:
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引用本文：

陈伟, 王贵玉, 陈瑛罡, 姜争, 刘正, 王猛, 王洪伟, 徐永鹏, 王锡山. 1810例左、右半结肠癌临床病理分析[J/OL]. 中华结直肠疾病电子杂志, 2013, 02(04): 162-165.

Wei CHEN, Gui-yu WANG, Ying-gang CHEN, Zheng JIANG, Zheng LIU, Meng WANG, Hong-wei WANG, Yong-peng XU, Xi-shan WANG. Statistical analysis of clinicopathologic characteristics of 1810 cases between right-and left-sided colon cancer.[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2013, 02(04): 162-165.

目的

通过研究左、右半结肠癌的临床及病理特征，探索其临床及生物学特性的区别，为后续开展的分子机制研究奠定基础。

方法

收集2001年1月至2010年12月在结直肠肿瘤外科，1810例经手术治疗结肠癌患者的临床及病理资料。其中男性984例，女性826例，平均年龄为59.7±11.9岁。右半结肠癌921例，占50.9%。应用卡方检验，对比分析左、右半结肠癌临床表型的区别。

结果

左、右半结肠癌在年龄(χ2＝11.4792，P<0.01)、性别(χ2＝6.8361，P<0.01)、大体型态(χ2＝4.7157，P<0.05)、T分期(P<0.01)、病理类型(χ2＝40.9880，P<0.01)、病理分化(χ2＝25.4816，P<0.01)、淋巴结切除数(χ2＝85.5153，P<0.01)中存在显著统计学差异。其中右半结肠癌患者中年龄组小于50岁和大于69岁发病率高；女性较男性多发；病理分期较晚的患者中粘液腺癌和印戒细胞癌多见。

结论

左、右半结肠癌在临床及生物学特性间存在差异，表明左、右半结肠癌可能为不同性质的肿瘤，存在不同的致癌机制。

关键词: 结肠肿瘤, 肿瘤，各部位, 病理学，临床
Objective

By comparing the clinicopathologic characteristics of right-and left-sided colon cancer, find out the clinical and biological differences between them and lay the foundation for the following study of the molecular mechanisms.

Methods

All clinical data were from the department of colorectal cancer of The Second Affiliated Hospital of Harbin Medical University.The patients with colorectal cancer(CRC)were treated with surgery during January 2001 to December 2010.There were 1810 cases with colonic cancer including 984 males and 826 females.The mean age was 59.7±11.9 years.The proportion of right-sided colon cancer was 50.9%.We compared the clinical differences of right and left colon cancer.

Results

Statistical analysis demonstrated that age, gender, histology, morphological appearance, T stage and the number of lymph nodes dissection had significant correlation with anatomic location.The proportion of right-sided colon cancer was relatively high in patients aged less than 50 years(51.8%)and more than 69 years(57.6%). Patients with right-sided colon cancer were more likely to be women, to be diagnosed with a more advanced stage, and to have more poorly differentiated tumors.

Conclusions

Different clinical and biological characteristics between right and left colon cancer were revealed.It demonstrated that right-and left-sided colon cancer may have a different carcinogenic mechanisms.

Key words: Colonic neoplasms, Neoplasms by site, Pathology, clinical
表1 患者基本情况分布情况表
一般情况 人数(%)
患者总数 1810
性别 ?
? ? 女 826(45.6)
? ? 男 ?
年龄 984(54.4)
? ? 均值±标准差 59.7±11.9
? ? <50 361(20.0)
? ? 50～59 502(27.7)
? ? 60～69 541(29.9)
? ? >69 406(22.4)
肿瘤部位 ?
? 右半 921(50.9)
? ? 回盲部＋升结肠 792(43.8)
? ? 横结肠 129(7.1)
? 左半 889(49.1)
? ? 降结肠 154(8.5)
? ? 乙状结肠 735(40.6)
表2 RCC与LCC患者的临床特点对比
因素 总例数 右半 左半 χ2值 P值
年龄 ? 921 889 ? ?
? <50 361 187(20.3%) 174(19.6%) 11.4792 0.0094
? 50～59 502 236(25.6%) 266(29.9%)
? 60～69 541 264(28.7%) 277(31.2%)
? >69 406 234(25.4%) 172(19.3%)
性别 ? ? ? ? ?
? 男 984 473(51.4%) 511(57.5%) 6.8361 0.0089
? 女 826 448(48.6%) 378(42.5%)
大体形态 ? ? ? ? ?
? 盘状隆起型 1051 512(51.4%) 539(60.6%) 4.7157 0.0299
? 侵润溃疡型 759 409(48.6%) 350(39.4%)
T分期 ? ? ? ? ?
? T1 5 2(0.2%) 3(0.3%) a <0.0001
? T2 197 80(8.7%) 117(13.2%)
? T3 283 156(16.9%) 127(14.3%)
? T4 1325 683(74.2%) 642(72.2%)
病理类型 ? ? ? ? ?
? 腺癌 1475 700(76.0%) 775(87.2%) 40.9880 <0.0001
? 粘液腺癌 318 206(22.4%) 112(12.6%)
? 印戒细胞 17 15(1.6%) 2(0.2%)
病理分化 ? ? ? ? ?
? 低分化 421 259(28.1%) 162(18.2%) 25.4816 <0.0001
? 中分化 1357 649(70.4%) 708(79.6%)
? 高分化 32 13(1.4%) 19(2.1%)
淋巴结切除数 ? ? ? ? ?
? 1～11 1197 516(56.0%) 681(73.9%) 85.5153 <0.0001
? ≥12 613 405(44.0%) 208(26.1%)
阳性个数 ? ? ? ? ?
? N0 1157 587(63.7%) 570(64.1%) 2.0098 0.3661
? N1 477 236(25.6%) 241(27.1%)
? N2 176 98(10.6%) 78(8.8%)
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