本文選題：粘膜發(fā)育異常 + 腸重復(fù)��； 參考：《南方醫(yī)科大學(xué)》2017年碩士論文

【摘要】：問(wèn)題的提出:在臨床病理工作中,我們發(fā)現(xiàn)大腸粘膜發(fā)育異常見(jiàn)于大腸癌病例中,并且可見(jiàn)癌旁大腸粘膜發(fā)育異常和大腸粘膜發(fā)育異常異型改變。在臨床隨訪過(guò)程中,我們發(fā)現(xiàn)含大腸粘膜發(fā)育異常的患者常發(fā)生大腸癌,含大腸粘膜發(fā)育異常的大腸癌患者預(yù)后不良。因此大腸粘膜發(fā)育異常與大腸癌發(fā)生是否有關(guān)?其臨床病理學(xué)意義何在?迄今為止,我們尚未見(jiàn)文獻(xiàn)報(bào)道對(duì)上述問(wèn)題的探討,為此我們進(jìn)行了本課題研究。研究目的:揭示大腸粘膜發(fā)育異常與大腸癌發(fā)生的關(guān)系及意義研究?jī)?nèi)容:探究大腸粘膜發(fā)育異常在大腸癌、大腸非癌性病變中的發(fā)生率有無(wú)差別,大腸粘膜發(fā)育異常與大腸癌發(fā)生的關(guān)聯(lián)性及大腸粘膜發(fā)育異常與大腸癌患者臨床病理參數(shù)及生存的關(guān)系。方法1.收集癌旁大腸粘膜發(fā)育異常和大腸粘膜發(fā)育異常的病例進(jìn)行病理學(xué)觀察和統(tǒng)計(jì)分析;2.觀察大腸病變患者病理切片并分別統(tǒng)計(jì)大腸粘膜發(fā)育異常在大腸癌、大腸非癌性病變中的發(fā)生情況;3.收集大腸病變患者臨床病理資料,應(yīng)用歷史性隊(duì)列研究法分別統(tǒng)計(jì)含大腸粘膜發(fā)育異常的患者大腸癌的發(fā)生情況;4.收集大腸癌患者臨床病理參數(shù)及生存情況,并分別統(tǒng)計(jì)大腸粘膜發(fā)育異常與臨床病理參數(shù)及生存的關(guān)系。結(jié)果1.大腸粘膜發(fā)育異常,包括癌旁大腸粘膜發(fā)育異常、大腸粘膜發(fā)育異常異型,與大腸癌病變有密切聯(lián)系。2.腸癌組腸重復(fù)發(fā)生率高于大腸非癌性病變組;腸癌組粘膜誤位發(fā)生率高于大腸非癌性病變組;腸癌組粘膜內(nèi)成腔發(fā)生率高于大腸非癌性病變組。3.腸重復(fù)暴露組與非暴露組在大腸癌的發(fā)生率上存在顯著性差異,含腸重復(fù)患者大腸癌患病相對(duì)危險(xiǎn)性比無(wú)腸重復(fù)患者增加4.218倍;粘膜誤位暴露組與非暴露組在大腸癌的發(fā)生率上存在顯著性差異,含粘膜誤位患者大腸癌患病相對(duì)危險(xiǎn)性比無(wú)腸重復(fù)患者增加3.421倍;粘膜內(nèi)成腔暴露組與非暴露組在大腸癌的發(fā)生率上存在顯著性差異,含粘膜內(nèi)成腔患者大腸癌危險(xiǎn)性比無(wú)粘膜內(nèi)成腔患者增加3.234倍。4.腸重復(fù)的存在與患者性別、年齡、腫瘤大小、腫瘤部位、腫瘤分化程度、腫瘤浸潤(rùn)層次、淋巴結(jié)轉(zhuǎn)移、遠(yuǎn)處轉(zhuǎn)移、病理分期均無(wú)明顯關(guān)聯(lián),腸重復(fù)是影響大腸癌患者生存的獨(dú)立預(yù)后因素;粘膜誤位的存在與患者腫瘤分化程度、腫瘤浸潤(rùn)層次有明顯關(guān)聯(lián),與患者性別、年齡、腫瘤大小、腫瘤部位、淋巴結(jié)轉(zhuǎn)移、遠(yuǎn)處轉(zhuǎn)移、病理分期均無(wú)明顯關(guān)聯(lián),粘膜誤位是影響大腸癌患者生存的獨(dú)立預(yù)后因素;粘膜內(nèi)成腔的存在與患者性別、年齡、腫瘤大小、腫瘤部位、腫瘤分化程度、腫瘤浸潤(rùn)層次、淋巴結(jié)轉(zhuǎn)移、遠(yuǎn)處轉(zhuǎn)移、病理分期均無(wú)明顯關(guān)聯(lián),粘膜內(nèi)成腔不是影響大腸癌患者生存的預(yù)后因素。結(jié)論大腸粘膜發(fā)育異常,包括腸重復(fù)、粘膜誤位和粘膜內(nèi)成腔,與大腸癌的發(fā)生有關(guān),可作為大腸癌的癌前病變。
[Abstract]:In the clinicopathological work, we found that the abnormal development of colorectal mucosa was found in colorectal cancer cases, and the abnormal development of adjacent colorectal mucosa and abnormal development of colorectal mucosa were observed. During clinical follow-up, we found that patients with abnormal development of large intestinal mucosa often developed colorectal cancer, and those with abnormal development of large intestinal mucosa had poor prognosis. Therefore, is the abnormal development of large intestine mucosa related to the occurrence of colorectal cancer? What is its clinicopathological significance? So far, we have not seen the literature report on the above issues, so we have carried out the research. Objective: to explore the relationship between colorectal mucosal dysplasia and colorectal carcinogenesis. The relationship between the abnormal development of colorectal mucosa and the occurrence of colorectal cancer and the relationship between the abnormal development of colorectal mucosa and the clinicopathological parameters and survival of colorectal cancer patients. Method 1. Pathological observation and statistical analysis were carried out in the patients with abnormal development of the adjacent colorectal mucosa and the abnormal mucosa of the large intestine. To observe the pathological sections of patients with colorectal diseases and to count the occurrence of abnormal development of large intestine mucosa in colorectal cancer and non-cancerous lesions of large intestine. To collect the clinicopathological data of patients with colorectal lesions and to calculate the incidence of colorectal cancer in patients with colorectal mucosal dysplasia by historical cohort study. The clinicopathological parameters and survival status of colorectal cancer patients were collected, and the relationship between abnormal development of colorectal mucosa and clinicopathological parameters and survival were analyzed. Result 1. Abnormal development of colorectal mucosa, including abnormal development of adjacent colorectal mucosa, abnormal development of colorectal mucosa, has a close relationship with colorectal cancer lesions. The rate of intestinal repeat in colorectal cancer group was higher than that in colorectal non-cancerous lesion group; the rate of mucosal misposition in colorectal cancer group was higher than that in colorectal non-cancerous lesion group; the incidence of intramucosal cavity formation in intestinal cancer group was higher than that in colorectal non-cancerous lesion group. There was significant difference in the incidence of colorectal cancer between the two groups. The relative risk of colorectal cancer in patients with intestinal duplication was 4.218 times higher than that in patients without intestinal duplication. There was a significant difference in the incidence of colorectal cancer between the exposure group and the non-exposure group. The relative risk of colorectal cancer in patients with mucosal misalignment was 3.421 times higher than that in patients without intestinal duplication. There was a significant difference in the incidence of colorectal cancer between the exposure group and the non-exposure group. The risk of colorectal cancer in patients with intramucosal cavities was 3.234 times higher than that in patients without intramucosal cavities. There was no significant correlation between the presence of intestinal duplication and sex, age, tumor size, tumor location, tumor differentiation, tumor invasion level, lymph node metastasis, distant metastasis, pathological stage. Intestinal duplication is an independent prognostic factor affecting the survival of colorectal cancer patients. There was no significant correlation between distant metastasis and pathological staging. Mucosal misplacement was an independent prognostic factor affecting the survival of colorectal cancer patients, and the presence of intramucosal cavities was associated with sex, age, tumor size, tumor location, tumor differentiation. Tumor invasion, lymph node metastasis, distant metastasis and pathological stage were not significantly correlated. Intramucosal lumen formation was not a prognostic factor for the survival of colorectal cancer patients. Conclusion the abnormal development of large intestine mucosa, including intestinal duplication, mucosal mislocation and intramucosal cavity formation, is associated with the occurrence of colorectal cancer and can be used as precancerous lesion of colorectal cancer.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.34

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本文編號(hào)：2085803