【摘要】：目的收集我科近年來收治的左半結(jié)腸癌與右半結(jié)腸癌患者的臨床表現(xiàn)、病理類型、生存預(yù)后等方面的資料,研究分析兩者在流行病學(xué)特征、臨床表現(xiàn)、病理類型及其生存預(yù)后方面的差異,為臨床精準(zhǔn)化、個體化地制定不同部位的結(jié)腸癌治療策略及發(fā)病機(jī)制研究提供奠定基礎(chǔ)。方法回顧性分析吉林大學(xué)附屬中日聯(lián)醫(yī)院2014年10月1日至2017年1月31日間住院治療的結(jié)腸癌患者277例(右半結(jié)腸癌128例,左半結(jié)腸癌149例)。采取調(diào)閱患者病歷資料及隨訪調(diào)查方式收集患者的年齡、性別、臨床癥狀、病理特征、治療方式等信息,并通過電話隨訪掌握患者的預(yù)后生存情況。采集數(shù)據(jù)后統(tǒng)一進(jìn)行整理分析,根據(jù)結(jié)腸癌病發(fā)病部位的不同把全部患者分為左半結(jié)腸癌組與右半結(jié)腸癌組。分別對兩組的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,構(gòu)成比差別采用c2檢驗(yàn),并且使用Kaplan-Meier繪制生存曲線,生存時間比較使用Log-rank分析,p0.05有顯著統(tǒng)計(jì)學(xué)差異。結(jié)果1、有277例結(jié)腸癌患者入組。其中,右半結(jié)腸癌患者為128例,占比46.21%,左半結(jié)腸癌患者為149例,占比53.78%。男性患者中左半結(jié)腸癌比例較高,而女性患者中右半結(jié)腸癌比例相對較高,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。2、分別統(tǒng)計(jì)比較左右半結(jié)腸癌患者在不同年齡段的分布,兩組存在顯著差異,P0.05,右半結(jié)腸癌發(fā)病年齡較晚。3、右半結(jié)腸癌患者主要臨床癥狀為腹痛、腹脹、腹瀉,腹部可捫及明顯包塊,而左半結(jié)腸癌患者主要臨床癥狀則包括血便、大便性狀及排便習(xí)慣改變?yōu)橹饕憩F(xiàn),兩組首發(fā)癥狀有顯著差異,P0.05,具有統(tǒng)計(jì)學(xué)意義。4、右半結(jié)腸癌腫瘤體積較左側(cè)更大,而病理分型多以中、低分化為主,淋巴轉(zhuǎn)移較多見,P0.05。而兩者在遠(yuǎn)處轉(zhuǎn)移方面未見顯著差異,P0.05。5、右半結(jié)腸癌確診時病理分析相對較晚,右半、左半Ⅲ、Ⅳ期總共占比51.56%VS 29.56%。兩組比較存在顯著差異,P0.05。6、左右半結(jié)腸癌Ⅰ、Ⅱ期預(yù)后相似,P0.05,Ⅲ、Ⅳ期預(yù)后較左半結(jié)腸癌差,P0.05。結(jié)論1、有277例結(jié)腸癌患者入組。其中,右半結(jié)腸癌患者為128例,占比46.21%,左半結(jié)腸癌患者為149例,占比53.78%。男性患者中左半結(jié)腸癌比例較高,而女性結(jié)腸癌患者中右半結(jié)腸癌占比較高。2、對搜集病例中患者的年齡分析結(jié)果顯示,右半結(jié)腸癌腫瘤發(fā)病年齡較左側(cè)晚。3、右半結(jié)腸癌患者主要臨床表現(xiàn)為腹痛、腹脹、腹瀉,腹部可捫及明顯包塊。而左半結(jié)腸癌患者多以血便、大便性狀及排便習(xí)慣改變?yōu)橹饕R床表現(xiàn)。4、右半結(jié)腸癌腫瘤體積較左側(cè)更大,而病理分型多以中、低分化為主,淋巴轉(zhuǎn)移較多見。而兩者在遠(yuǎn)處轉(zhuǎn)移方面未見顯著差異。5、右半結(jié)腸癌TNM分期較晚,左半結(jié)腸癌發(fā)病時TNM分期更早。6、左右半結(jié)腸癌Ⅰ、Ⅱ期預(yù)后相似,右半結(jié)腸癌Ⅲ、Ⅳ期預(yù)后較左半結(jié)腸癌短。
[Abstract]:Objective to collect the clinical manifestations, pathological types, survival and prognosis of patients with left and right colon cancer treated in our department in recent years, and to study and analyze their epidemiological characteristics and clinical manifestations. The differences in pathological types and survival and prognosis lay a foundation for clinical precision and individualized study on the therapeutic strategies and pathogenesis of colon cancer in different parts. Methods 277 patients with colon cancer (128 right colon cancer and 149 left colon cancer) who were hospitalized from October 1, 2014 to January 31, 2017 in Sino-Japanese Union Hospital affiliated to Jilin University were retrospectively analyzed. The patient's age, sex, clinical symptoms, pathological features and treatment methods were collected by reading the patient's medical records and follow-up investigation, and the prognosis and survival of the patients were obtained by telephone follow-up. After collecting data, the patients were divided into left colon cancer group and right colon cancer group according to the location of colon cancer. The two groups of data were statistically analyzed, the difference of constitution ratio was measured by c2 test, and the survival curve was drawn by Kaplan-Meier, and the survival time was compared by Log-rank analysis. There was significant difference between the two groups (p0.05). Results 1. 277 patients with colon cancer were enrolled. There were 128 patients with right colon cancer (46.21) and 149 patients with left half colon cancer (53.78%). The proportion of left colon cancer in male patients was higher than that in female patients, the difference was statistically significant (p0.05). 2. The distribution of left and right colon cancer patients in different age groups was compared. There was significant difference between the two groups, P0.05, the age of onset of right hemicolon was late. The main clinical symptoms of patients with right hemicolon were abdominal pain, abdominal distension, diarrhea, palpable abdominal mass. The main clinical symptoms of patients with left hemicolon cancer included blood stool, defecation traits and defecation habits. There was a significant difference between the first symptoms of the two groups (P0.05, with statistical significance. 4) The tumor size of the right colon cancer was larger than that of the left, while the pathological classification was mainly middle and low differentiation, and lymphatic metastasis was more common (P0.05. 0. 05). However, there was no significant difference in distant metastasis between the two groups (P0.05.5). The pathological analysis of right hemicolon carcinoma was relatively late. The ratio of 51.56%VS 29.5656 in stage 鈪，

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