摘要
目的分析比较不同病灶部位老年结肠癌的特点。方法回顾性分析2014年9月至2016年9月在复旦大学附属华东医院病理确诊且初发的老年结肠癌患者196例,分为左半结肠癌(LCC)组及右半结肠癌(RCC)组比较其病理特征、肿瘤标志物及免疫组化的差异,以及高度、低度微卫星不稳定(MSI-H、MSI-L)及微卫星稳定(MSS)结肠癌在老年患者中的特点,计数资料采取2检验或Fisher’s精确检验分析。结果 RCC患者TNM II期、III期比例较LCC高(31.0%vs26.0%,49.0%vs41.7%);低分化腺癌(13.0%vs7.3%)及黏液腺癌(19.0%vs4.2%)更多见,差异有统计学意义。在各项肿瘤标志物检测方法的比较中,检测联合检测CA199+CEA+CA125+CY211检出率最高(63.3%),差异有统计学意义。MSI-H结肠癌多见于RCC,女性患者更多,较MSI-L/MSS结肠癌低分化腺癌及黏液腺癌所占比例高,差异均有统计学意义。Ki-67水平与结肠癌的生物学行为无相关性。结论 LCC和RCC在临床、病理特征及免疫组化等方面存在差异。
Objective To analyze the characteristics o f left-sided and right-sided colon cancers in elderly patients. Methods A retrospective analysis was made to the clinical data of 196 elderly patients with colon cancer confirmed in Huadong Hospital; the 196 cases were divided into 2 groups： RCC （right-sided colon cancer） group and LCC （left-sided colon cancer） group; a comparative study was made to the differentiations in pathology, biomarkers, immunohistochemistry between the 2 groups and the characteristics of microsatellite instability （MSI-L, MSI-H） and microsatellite stability （MSS） in colon cancer of the elderly patients were studied; categorical variables were examined by chi-square test or Fisher＇s exact test. Results The proportion of stage Ⅱ and Ⅲ in RCC group was higher than that in LCC group （31.0% vs 26.0%, 49.0% 41.7%）, as well as the proportion of poorly differentiated adenocarcinoma （13.0% 7.3） and the proportion of mucinousadenocarcinoma （19.0% vs 4.0%）, the difference was of statistical significance; the combined detection of CA199＋CEA ＋ CA125 ＋ CY211 was of the highest detection rate （63.3%）, the difference was of statistical significance; MSI-H was commonly seen in RCC patients, more in female RCC patients, with a significantly higher incidence of mucinous and poorly differentiated adenocarcinoma than MSI-L/MSS ones; the level of Ki-67 had no relevance with the biological behavior of colon cancer. Conclusions RCC and LCC are significantly different in clinical, pathological and immunohistochemical aspects; more individual therapeutic project should be made for elderly patients with colon cancer.
出处
《老年医学与保健》
CAS
2017年第4期298-300,313,共4页
Geriatrics & Health Care
基金
基金项目:上海市卫生计生系统重要薄弱学科建设-老年医学(2015ZB0501)
上海市老年医学临床重点实验室(13dz2260700)
