青年大肠癌92例发病及病理特点分析.docVIP

青年大肠癌92例发病及病理特点分析 　 作者：李秋元，俞晶，郑忠生，陈素钻 【关键词】 结直肠肿瘤 摘要：目的：分析青年大肠癌的发病特点和病理特征与中老年大肠癌的不同，为青年大肠癌的预防和治疗提供理论依据。方法：总结我院5年间收治的92例年龄低于35岁青年大肠癌资料进行筛选和研究，对患者性别、内镜资料、临床表现、病理及c-erbB-2蛋白表达和治疗情况进行统计分析，与同期中老年病例作对照。结果：血色素测定女性组明显低于男性组（P＜0.01)；青年组大肠癌在内镜特征、肿瘤部位和c-erbB-2检测方面与中老年组患者并无差异，在粘液血便、排便习惯改变、肠梗阻发生率，粘液腺癌、未分化癌发生率，Dukes分期C-D期相比较，差异有显著性意义（p＜0.05)。结论：青年人大肠癌确诊晚，误诊多，恶性度高，预后差；贫血可能是提示青年女性大肠癌具有诊断价值的参考指标；检测C-erbB-2蛋白表达可提示预后并指导临床治疗。 　　关键词： 结直肠肿瘤； 病理学； 临床； 青年 　　Analysis of Incidence and Pathological Characteristics of 92 Young Patients with Colorectal Carcinoma 　　Abstract： Objective： To analyzes the incidence and pathological characteristic of colorectal carcinoma in young patients and to explore the possibility of screening and preventing hereditary colorectal carcinoma. Method： 92 young patients with colorectal carcinoma under 35 years of ages were reviewed as to their sex, endoscopes datum, clinic representation, pathology, expression of c-erbB-2 protein and cure effects. Result： The hemoglobin was lower in the female group than male group(p＜0.001); The endoscopes datum, position and expression of C-erbB-2 protein of both groups showed no statistical difference, but the rate of mucor-bloody stools, change of bowel movement habit, adenocarcinoma, alvine block, mucinous adenocarcinoma, undifferentiated carcinoma, Dukes stage C and D were significant difference(p＜0.05) in young group than old group. Conclusion： Colorectal carcinoma in young patients are lower diagnose, higher error diagnose, poorer differentiation of tumour, worse cure; Colorectal carcinoma in young females might present with anemia that should be excluded in differentiate diagnose; Expression of C-erbB-2 protein might be used as a prognostic marker for therapy. 　　Key words： Colorectal carcinoma; Pathology； Clinical; Adolescent 　　大肠癌是我国常见的消化道肿瘤，发病年龄以老年人多见，近年来发病率有逐步增高的趋势，越来越多的资料表明青年人大肠癌发病率逐年增高。由于大肠癌早期临床表现不典型，误诊率高，常常延误病情，而青年人大肠癌由于组织分类较差，治疗效果不理想，故了解青年人大肠癌的临床特点实属必要。汕头大学医学院第一附属医院自2000年1月至2005年12月经内镜及病理确诊的720例大肠癌，其中35岁以下的大肠癌92例，占12