發(fā)布時間：2018-11-10 13:12

【摘要】：目的:探討同時性多原發(fā)性結(jié)直腸癌(Synchronous Colorectal Carcinoma,SCC)的臨床發(fā)病特點、病理分期分型、手術(shù)治療、預(yù)后及術(shù)后隨訪,以提高臨床醫(yī)師對于同時性多原發(fā)性結(jié)直腸癌的認(rèn)識。方法:回顧分析自2012年1月至2016年12月皖南醫(yī)學(xué)院第一附屬醫(yī)院普外科所有科室收治的經(jīng)術(shù)后病理確診的748例結(jié)直腸手術(shù)患者,剔除8例家族性結(jié)腸腺瘤病(Familial Adenomatous Polyposi,FAP)患者,剩余740例結(jié)直腸癌患者,對這些患者按照登記的身份證號碼篩選出14例SCC患者進(jìn)行分析。以性別、年齡、病灶分布、病理分型、臨床分期、生存率等參數(shù)與同一時期726例單發(fā)性結(jié)直腸癌患者進(jìn)行對比分析,用SPSS13.0統(tǒng)計學(xué)軟件處理相關(guān)數(shù)據(jù)。結(jié)果:本研究14例同時性多原發(fā)性結(jié)直腸癌患者中,男性13例,女性1例,男女比例為13:1;發(fā)病年齡在43-87歲之間,平均年齡61.6歲。共發(fā)現(xiàn)癌灶30處,升結(jié)腸發(fā)病率26.7%,橫結(jié)腸發(fā)病率16.7%,降結(jié)腸發(fā)病率13.3%,乙狀結(jié)腸發(fā)病率23.3%,直腸發(fā)病率20.0%,同時性多原發(fā)性結(jié)直腸癌的發(fā)病率1.89%。除1例并發(fā)轉(zhuǎn)移癌患者行姑息性手術(shù),其余患者均行根治術(shù),術(shù)后病理類型以腺癌多見83.3%,少數(shù)合并有粘液腺癌10.0%;術(shù)后對所有患者進(jìn)行隨訪,其1,3,5年生存率分別為64.3%,28.6%,7.1%。結(jié)論:SCC患者好發(fā)年齡在60歲左右,男性發(fā)病患者較女性多,好發(fā)部位以升結(jié)腸、乙狀結(jié)腸及直腸多見,有手術(shù)指征患者的手術(shù)方案需要結(jié)合腫瘤相關(guān)特點綜合考慮。
[Abstract]:Objective: to investigate the clinical features, pathological staging, surgical treatment, prognosis and postoperative follow-up of simultaneous multiple primary colorectal cancer (Synchronous Colorectal Carcinoma,SCC) in order to improve clinicians' understanding of concurrent multiple primary colorectal cancer. Methods: from January 2012 to December 2016, 748 patients with colorectal surgery were treated in all departments of General surgery, first affiliated Hospital of Southern Anhui Medical College, and 8 patients with familial colonic adenomatosis (Familial Adenomatous Polyposi,) were removed. FAP), the remaining 740 patients with colorectal cancer, 14 patients with SCC were screened according to the registered ID number. Sex, age, lesion distribution, pathological classification, clinical stage, survival rate and other parameters were compared with 726 patients with single colorectal cancer in the same period. The data were analyzed by SPSS13.0 software. Results: in this study, there were 13 males and 1 female, the ratio of male to female was 13: 1, and the onset age was between 43 and 87 years, with an average age of 61.6 years. A total of 30 cancer foci were found, the incidence of ascending colon was 26.7cm, the incidence of transverse colon was 16.7, the incidence of descending colon was 13.3, the incidence of sigmoid colon was 23.3m, and the incidence of rectum was 20.0. The incidence of concurrent multiple primary colorectal cancer is 1.89. Palliative operation was performed in one patient with metastatic carcinoma, radical resection was performed in all the patients, the pathological type was 83.3% in adenocarcinoma and 10.0 in a few cases with mucinous adenocarcinoma. All the patients were followed up after operation. The survival rates of 1 and 5 years were 64.3% and 28.6%, respectively. Conclusion: the predilection age of SCC patients is about 60 years old, the incidence of male patients is more than that of women, and the most common sites are ascending colon, sigmoid colon and rectum. The operative plan of patients with surgical indications should be considered in combination with tumor-related characteristics.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.34

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