【作者】 苏伟；

【导师】 刘铜军；

【作者基本信息】 吉林大学 ， 临床医学， 2007， 硕士

【摘要】 目的:分析青年大肠癌的发病特点和病理特征,为青年大肠癌的预防和治疗提供理论依据。方法:回顾性分析我院近5年间收治的36例年龄低于30岁青年大肠癌资料,进行筛选和研究,对患者性别、病理、临床表现、治疗、预后进行分析。结果:青年大肠癌占同期大肠癌的7.66%;男女发病率无明显差异;以直肠、乙状结肠高发。黏液腺癌和印戒细胞癌的发生率为44.4%,显著高于成年患者的8.7%。青年组晚期病例(Duke’s C + D)比例为75%,显著高于成年的36.5%。青年组三年生存率(27.3%)显著低于老年组五年生存率(61.1%),但病期相同的青年和老年患者,预后无明显差异。结论:①我国青年大肠癌发病率较国外为高,且近年来发病率有进一步增高的趋势;好发部位仍以直肠、乙状结肠为主;恶性度高的组织学分型所占比例多。②由于青年大肠癌临床特点不典型,患者、医生重视度不够,误诊率较高,待到发现时已延误了最佳治疗时机。③青年大肠癌预后差,主要原因在于未能及时正确诊断,而延误治疗,所以开展便潜血试验普查;对高危人群定期复查;重视直肠指诊将大大提高青年大肠癌的预后。更多还原

【Abstract】 ObjectiveTo analyzes the incidence and pathological characteristic of colorectal carcinoma in young patients and to explore the possibility of screening and p reventing hereditary colorectal carcinoma.Research design and methodWe study 36 young patients with colorectal carcinoma under 30 years of ages in The first hospital of Jilin University from December 2001 to December 2006, and reviewed as to their sex, the early syndrome, clinic repsentation, pathology, cure and prognosis.ResultsThe number of young colorectal carcinoma patinet is 7.66% of the whole number. The sex rat io was 20: 16 (male to female), 66.7% (24cases) of them were found in the rectum, and 13.9% (5 cases) of them were found in colon sigmoideum. The rate of mucinous adenocarcinoma and signet ring cell cancer was 44.4% in the young group, which was higher significantly than that (8.7%) in the old group. The rate of advanced stage (Duke’s C+D) in the young patients was 75%, which was higher than that (36.5%) in old group. The three year survival rate (27.3%) in the youngers was significantly lower than that (61.1%) in the olders. However, the prognosis in the young cases hed no significant difference compared with old cases if thestage were the same.Conclusions1、The incidence of the colorectal carcinoma among the young in China is higher than that in foreign countries, and it continues to show an upward tendency recentlly. The predilection site of the disease is the rectum and colon sigmoideum, and the tissue type with a high malign- ant degree has a high rate.2、The misdiagnosis rate of the colorectal carcinoma in young patients is high because of its untypical clinical characteristic .On the other hand, that some patiemts amd doctors don’t think highly of the disesse also results in the high misdiagnosis rate. Accordingly, it’s easiy to miss the best chance of treatment.3、The poor prognosis is due to a delay of the treatment. In a word, that developing the census of the faeces occult blood experiment, reexaminating the high-risk group and paying much attention to the digital rectal examination can improve the prognosis of the disease greatly.更多还原