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Site Distribution of Colorectal Cancer: A Retrospective Study of 1198 Cases

結腸直腸癌的位置分佈:1198病例之回朔性研究

摘要


本回朔性研究的目的在於分析並探討台大醫院在過去十年中,結腸直腸癌位置分佈(site distribution)的演變情形,並與國外的報告相互比較其差異。共有1198個腺癌病例合於研究標準,按照診斷的年份,把這些病例歸類到兩個五曆年族群(A:1979-1983: B:1984-1988)。在這兩個族群中,再按位置,年齡,性別加以區分統計;我們比較分析這兩個五曆年族群得如下結果:1.在這十年當中,結腸直腸癌的位置分佈相當穩定,直腸癌在兩族群中都佔一半左右的比率(A:50%; B:51%),其它部位腸癌的比率亦無明顯變動。2.不論男女,B族群的平均年齡均有意義地較A族群高(男60.6±1.9vs.56.0±2.6;女57.7±2.1vs.54.6±2.5),這主要是人口老化導致高年病患增加之故。3.女性患者的平均年齡均較男性低(如上數據所示),原因未明,可能是致癌基因(Oncogen)及性荷爾蒙扮演著某些特定角色。4.在四個主要解剖學位置上,結腸直腸癌病患的男女比率,不論是同一族群中或者是不同族群中互相比較都幾乎相同,雖然我國人口有明顯老化的現象,腸癌的診斷技術亦有長足的進步,但是並沒有發生如西方國家的腸道老化(aging gut)現象(直腸癌比率下降,右邊結腸癌比率上昇)。我們認為結腸直腸癌的起因,和病灶分佈部位在各民族間可能有所不同。

關鍵字

分佈 結腸直腸癌 年齡 性別

並列摘要


A retrospective study investigating 1198 cases of colorectal cancer was undertaken to ascertain whether the site distribution pattern of colorectal cancer changed according to time trends and was influenced by age and/or sex. These patients were divided into two groups according to two five-year calender periods from 1979 to 1988 (group A: 1979-1983; group B: 1984-1988). In both groups, a considerable portion of cancers were located in the rectum (group A: 50%; group B: 51%). Comparing these patients, we found no significant change in site distribution between these two groups (p=0.34), neither was there any significant change in the distribution pattern by sex among patients of the same or different groups. The percentage of old patients above the age of 70 in the right colon cancer group remained unchanged between these two calender periods (14% vs. 14%). But both male and female patients of group B were significantly older than those of group A (male: 60.6±1.9 vs. 56.0±2.6; female: 57.7±2.1 vs. 54.6±25; p<0.05). We conclude that in spite of increase in number and mean age of patients with colorectal cancer which was thought to be the consequence of longer life expectancy, analysis of our data did not give support to the pheonomenon of ”aging gut” or rightward shift of colon cancer observed in western countries.

並列關鍵字

distribution colorectal cancer age sex

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