發(fā)布時(shí)間：2018-11-11 19:05

【摘要】：目的： 探討膽石癥并發(fā)原發(fā)性大腸癌者臨床特點(diǎn)。 材料和方法： 本研究隨機(jī)選取2011年11月至2013年12月期間于吉林大學(xué)白求恩第一醫(yī)院經(jīng)術(shù)后病理明確診斷為大腸癌，其中經(jīng)腹部CT或（和）消化系彩超明確診斷為膽石癥患者共65人，不合并膽道系統(tǒng)疾病者65人。從發(fā)病年齡、性別、癌灶數(shù)目、發(fā)病部位、病理類(lèi)型、分化程度、分期進(jìn)行比較。應(yīng)用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)分析。 結(jié)果： 1.膽石癥并發(fā)大腸癌組患者男女比例較大腸癌組低，但其差異無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）。 2.膽石癥并發(fā)大腸癌組患者以55~79歲年齡段所占比例最高，占75%以上，中位年齡為68歲；大腸癌組患者以45~74歲年齡段所占比例最高，占75%以上，中位年齡為59歲，兩者中位年齡比較差異有統(tǒng)計(jì)學(xué)意義（P＜0.01）。膽石癥并發(fā)大腸癌組老年患者與大腸癌組比較具有顯著差異（P＜0.01）。 3.膽石癥并發(fā)大腸癌組患者中多原發(fā)癌4例，與大腸癌組比較無(wú)統(tǒng)計(jì)學(xué)差異（P＞0.05）。 4.膽石癥并發(fā)大腸癌組患者病理類(lèi)型以腺癌最多見(jiàn)，其次為粘液腺癌，這與大腸癌組相似（P＞0.05）。 5.膽石癥并發(fā)大腸癌組低（未）分化病灶13個(gè)，占18.84%，，高于大腸癌組的7.35%，差異具有統(tǒng)計(jì)學(xué)意義（P＜0.05）。 6.膽石癥并發(fā)大腸癌組晚期患者較大腸癌組高，其中處于Ⅲ期患者兩組間有顯著性差異（P＜0.01）。 結(jié)論： 1.60歲以上膽石癥患者發(fā)生大腸癌危險(xiǎn)性增高，而與性別無(wú)明顯相關(guān)性。提示我們60歲以上膽石癥患者，尤其是膽石癥病程較長(zhǎng)者，應(yīng)該定期進(jìn)行腸道檢查。 2.膽石癥患者右半結(jié)腸癌發(fā)病率高。 3.膽石癥并發(fā)大腸癌組織傾向于低分化，發(fā)生局部淋巴結(jié)轉(zhuǎn)移者明顯增多，表明膽石癥并發(fā)的大腸癌侵襲性較強(qiáng)。
[Abstract]:Objective: to investigate the clinical features of cholelithiasis complicated with primary colorectal cancer. Materials and methods: from November 2011 to December 2013, colorectal cancer was diagnosed by pathology in the first Hospital of Bethune, Jilin University, from November 2011 to December 2013. 65 patients with cholelithiasis were diagnosed by transabdominal CT or / and color Doppler ultrasonography, and 65 patients were not complicated with biliary system diseases. Age, sex, number of cancer foci, location, pathological type, degree of differentiation and stage were compared. SPSS17.0 statistical software was used to analyze the data. Results: 1. The ratio of male and female in cholelithiasis complicated with colorectal cancer group was lower than that in colorectal cancer group, but the difference was not statistically significant (P > 0.05). 2. In the group of cholelithiasis complicated with colorectal cancer, the proportion of 55 ~ 79 years old was the highest (75%), and the median age was 68 years old. The proportion of colorectal cancer patients aged 45 to 74 years old was the highest, accounting for more than 75%, the median age was 59 years old. The difference between the two groups was statistically significant (P < 0.01). There was a significant difference between the elderly patients with cholelithiasis complicated with colorectal cancer and the colorectal cancer patients (P < 0.01). 3. There were 4 cases of multiple primary carcinoma in cholelithiasis complicated with colorectal cancer group, and there was no significant difference compared with colorectal cancer group (P > 0.05). 4. Adenocarcinoma was the most common pathological type in patients with cholelithiasis complicated with colorectal cancer, followed by mucinous adenocarcinoma, which was similar to that in colorectal cancer group (P > 0.05). 5. There were 13 poorly differentiated lesions (18.84%) in the cholelithiasis complicated with colorectal cancer group, which was higher than 7.35 in the colorectal cancer group (P < 0.05). 6. The late stage of cholelithiasis complicated with colorectal cancer group was higher than that of colorectal cancer group, and there was significant difference between the two groups in stage 鈪

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