老年结肠癌临床及病理相关因素回顾性分析

Retrospective Analysis of Clinical and Pathological Features of Colon Cancer in the Elderly

中文关键词: 老年, 结肠癌, 肿瘤标志物, Ki-67, 微卫星不稳定

英文关键词: elderlycolon cancerbiomarkerKi-67microsatellite instability (MSI)

中文摘要:

      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x2检验或Fisher's精确检验分析.结果 RCC患者TNMⅡ期、Ⅲ期比例较LCC高(31.0％ vs 26.0％,49.0％ vs 41.7％);低分化腺癌(13.0％ vs 7.3％)及黏液腺癌(19.0％ vs 4.2％)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,老年结肠癌患者应制定更为个体化诊疗方案

英文摘要:

      Objective To analyze the characteristics of 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％ vs 41.7％),as well as the proportion of poorly differentiated adenocarcinoma (13.0％ vs 7.3) and the proportion of mucinous adenocarcinoma (19.0 ％ vs 4.0 ％),the difference was of statistical significance;the combined detection of CA 199 + CEA + CA 125 + C Y211 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 ofmucinous 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.