论文部分内容阅读
目的分析中国东北地区遗传性非息肉病性结直肠癌(HNPCC)患者的临床病理特点。方法对1982～2011年期间中国医科大学附属第四医院和辽宁省肿瘤医院登记的73例符合Amsterdam标准及28例符合Bethesda指导纲要的101例先证者组成HNPCC组,随机选取同期收治的散发性结直肠癌患者272例组成散发组,回顾性分析、比较2组的临床病理特点。结果 HNPCC组发病年龄≤45岁者24例(23.8%)、肿瘤位于近端结肠31例(30.7%)、多原发癌26例(25.7%)、肠外恶性肿瘤13例(12.9%)、黏液腺癌32例(31.7%)、Ⅰ+Ⅱ期68例(67.3%)、高-中分化70例(69.3%)、有淋巴结转移者33例(32.7%),散发组分别为12例(4.4%)、54例(19.9%)、15例(5.5%)、11例(4.0%)、30例(11.0%)、127例(46.7%)、152例(55.9%)、140例(51.5%),2组比较差异均有统计学意义(P<0.05),但2组间性别比较差异无统计学意义(P>0.05)。同时HNPCC组肠外肿瘤依次是子宫内膜癌3例、膀胱癌3例、乳腺癌2例、脑瘤2例、卵巢癌1例、胃癌1例、肺癌1例。结论中国东北地区HNPCC具有发病年龄早、好发于近侧结肠、多原发癌常见、肠外恶性肿瘤发生率高、黏液腺癌多见、肿瘤分期早、分化程度较好和淋巴结转移少见的特点,临床病理特征仍然是诊断HNPCC患者或可疑患者的首选方法。
Objective To analyze the clinicopathological features of hereditary nonpolyposis colorectal cancer (HNPCC) in northeast China. Methods A total of 73 cases of HNPCC who registered with the Fourth Affiliated Hospital of China Medical University and Liaoning Provincial Cancer Hospital between 1982 and 2011 were enrolled in the HNPCC cohort, which were in line with the Amsterdam standard and 28 cases with Bethesda guidelines. Randomly selected sporadic 272 cases of colorectal cancer patients were disseminated, retrospectively analyzed, the clinical and pathological features of the two groups were compared. Results Twenty-four patients (23.8%) were diagnosed as HNPCC at the age of 45 years or younger, 31 (30.7%) had tumors in the proximal colon, 26 (25.7%) had multiple primary cancers, and 13 (12.9%) had parenteral malignancies Mucinous adenocarcinoma in 32 cases (31.7%), Ⅰ + Ⅱ 68 cases (67.3%), high-moderately differentiated 70 cases (69.3%), 33 cases of lymph node metastasis (32.7% 4.4%), 54 cases (19.9%), 15 cases (5.5%), 11 cases (4.0%), 30 cases (11.0%), 127 cases (46.7%), 152 cases (55.9%), 140 cases %). There was significant difference between the two groups (P <0.05), but there was no significant difference in gender between the two groups (P> 0.05). At the same time, there were 3 cases of endometrial cancer, 3 cases of bladder cancer, 2 cases of breast cancer, 2 cases of brain tumor, 1 case of ovarian cancer, 1 case of gastric cancer and 1 case of lung cancer. Conclusion HNPCC in northeastern China had early onset, occurred in the proximal colon, common in multiple primary cancers, high incidence of extraintestinal malignancies, mucosal adenocarcinoma more common, early tumor stage, better differentiation and lymph node metastasis Features, clinical and pathological features are still the preferred method of diagnosis of HNPCC patients or suspicious patients.