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美国外科医师学院癌肿委员会(COC)定期复习癌肿病例的诊治标准和随访工作,并每年发表全国性调查结果.1983年曾分析943家医院治疗39502例癌症病人的结果,其中12682例为结肠癌和4579例直肠癌;1988年曾调查了16527例结肠癌和5696例直肠癌.共收回调查资料39674例,剔除记录不完整者172例,总计为39502例,其中长期和短期随访结肠癌分别为12682例和16527例,直肠癌分别为4597例和5696例,结肠和直肠癌调查病例分别占美国全部病例的16%和14%.分析结果 (一)病人 1988年病人的中位值年龄结肠癌为72.1岁,直肠癌为69.3岁,与1983年调查的相仿;男性病例稍增加,由1983年47.8%增至1988年49.3%.其中直肠癌增长较结肠癌稍多.(二)肿瘤部位 1983年盲肠和升结肠占33.8%,乙状结肠占36.3%,而至1988年则分别为35.8%和34.7%.多数直肠癌位于远端直肠,68.6%为良好或中度分化.(三)症状 1988年调查结肠和直肠癌主诉腹痛分别为40.5%和20.9%,排便习惯改变为33.2%和43.3%.60.4%直肠癌有直肠出血,而结肠具粪便隐血自1983年的27.8%增加至1988年的34.3%.(四)诊断 诊断方法中,1988年使用内镜、活检和CT扫描增高,但钡灌肠应用减少.
The American College of Surgeons Cancer Council (COC) regularly reviews the diagnosis, treatment, and follow-up of cancer cases and publishes nationwide survey results. In 1983, 943 hospitals were analyzed for 39,502 cancer patients, of which 12682 were colonic. Cancer and 4579 cases of rectal cancer. In 1988, 16527 cases of colon cancer and 5696 cases of rectal cancer were investigated. A total of 39,674 cases of investigation data were retrieved, 172 cases with incomplete records were excluded, a total of 39,502 cases, of which long-term and short-term follow-up colon cancer There were 12,682 cases and 16,527 cases of rectal cancer, 4597 cases and 5,696 cases of rectal cancer. The cases of colon and rectal cancer accounted for 16% and 14% of all cases in the United States. Analysis Results (A) Patients’ median age in 1988 Cancer was 72.1 years old, and rectal cancer was 69.3 years old. It was similar to that of 1983 survey. Male cases increased slightly from 47.8% in 1983 to 49.3% in 1988. The growth of rectal cancer was slightly more than that of colon cancer. (II) Tumor site In 1983, the cecum and ascending colons accounted for 33.8%, sigmoid colon 36.3%, and by 1988 they were 35.8% and 34.7%, respectively. Most rectal cancers were located in the distal rectum, and 68.6% were good or moderately differentiated. (c) Symptoms 1988 Annual survey of colon and rectal cancer In 40.5% and 20.9% of the cases respectively, bowel habit changed to 33.2% and 43.3%. 60.4% of rectal cancer had rectal bleeding, while colonic occult blood increased from 27.8% in 1983 to 34.3% in 1988. (IV) Diagnostic Diagnosis In the method, endoscopic, biopsy, and CT scans were used in 1988, but the use of barium enema was reduced.