同时性结直肠癌的临床研究

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目的探讨同时性结直肠癌临床、病理及诊治特殊性。方法对326例资料完整的初诊结直肠癌进行回顾性分析,将患者分为单发癌、同时性癌两组,并对两组临床、组织病理学差别进行统计学分析。结果第一癌病灶分布与单发癌无差异,分化程度、分期优于单发癌;第二癌与单发癌在病灶分布、分化程度及分期有差异。单发癌患者中有11·6%合并腺瘤、合并多发息肉者42·2%;同时性癌患者中合并腺瘤者34·8%,合并多发息肉者78·3%,两组差异有统计学意义。对癌灶行根治性切除,56·9%多发息肉于术后2~3个月内行电灼术;79·1%腺瘤行一期局部切除或肠段切除术,39·1%行二期电灼术。结论同时性结直肠癌的临床、病理学具有特殊性,术前病灶的全面判断、系统的外科治疗策略以及术后及时、严格随访具有重要意义。 Objective To investigate the clinical, pathological and diagnosis and treatment of concurrent colorectal cancer. Methods 326 cases of newly diagnosed colorectal cancer were retrospectively analyzed. The patients were divided into single cancer and concurrent cancer, and the clinical and histopathological differences between the two groups were statistically analyzed. Results There was no difference in the distribution of the first cancer lesion with that of the single lesion. The differentiation degree and stage were superior to the single lesion. The second lesion and the single lesion were different in the distribution, differentiation and staging of the lesion. Among patients with solitary adenocarcinoma, 11.6% had adenomas and 42.2% had multiple polyps. In patients with adenocarcinoma, 34.8% had adenomas and 78.3% had polyp. There was a significant difference between the two groups Statistical significance. Radical resection of the tumor, 56.9% of multiple polyps in the 2 to 3 months after surgery underwent cautery; 79.1% of adenomas underwent a partial resection or bowel resection, 39.1% of the second line Period of cautery. Conclusions The clinical and pathological features of concurrent colorectal cancer are special. The comprehensive judgment of preoperative lesions, systematic surgical treatment strategies, and prompt and strict postoperative follow-up are of great significance.
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