Clinicopathologic Characteristics in Colorectal Adenocarcinoma and Their Relationship to Survival

高雄醫學院外科自民國70年1月起，對於大腸直腸癌病人的腫瘤分期，除了已往的Astler-Coller modification of Dukes’ classification外，還根據日本大腸直腸癌研究會公布的 “大腸直腸癌臨床及病理研究規約” 處理。本研究目的是評估這個腫瘤分期系統作為大腸直腸癌預後根據的可行性及探討對存活率也有影響的一些臨床和病理特徵，這些因素在病人以病理分期歸成一類時不易被識出，因此本研究可幫助找出高復發率的病人可早期給予輔助性治療-放射線治療、免疫療法及化學療法。本報告乃依據最初的327例可切除的大腸直腸癌作研究。包括於本研究的臨床和病理特徵有：年齡、性別、症狀發生至治療時間、腫瘤部位、腫瘤佔據腸腔圓周的百分比、轉移淋巴腺數、癌細胞侵犯腸壁深度、肉眼形狀、癌細胞組織型態及腫瘤分期。結果顯示腫瘤分期與存活率有相當密切的關連。其他併隨統計學上有意義差的5年存活率的因素有：小於40歲的年輕人，症狀發生至治療時間低於6個月者，腫瘤佔據腸腔圓周2/3以上者，有較多數淋巴腺轉移者，低分化腺癌，侵犯鄰近器官者及潰瘍浸潤型腫瘤。全部病例5年存活率為53.4%。

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並列摘要

In January 1981 at the surgical department of the Kaohsiung Medical College Hospital, we began a longterm clinicopathological study of colorectal adenocarcinoma according to “The General Rules for Clinical and Pathologi-cal Studies on Cancer of the Colon, Rectum and Anus” issued by the Ja-paneses Research Society for Cancer of the Colon and Rectum. The aim was to evaluate this type of tumor’s staging system as a guide to prognosis, and to determine the effects of several clinicopathological characteristics on survival. The data presented are based on the findings in the first 327 pa-tients whose tumors were resectable. The clinicopathological variables in-cluded in this study were: age, sex, duration of symptoms, tumor location, the proportion of the bowel wall circumference involved, numbers of lymph nodes involved, depth of the cancer invasion, gross type, histological type and microscopic stage. The microscopic stage was found to be related strong-ly to survival. Other variables associated with significantly poorer five-year survival were: age under 40 years, duration of preoperative symptoms shorter than 6 months, a tumor occupying more than two-thirds of the bowel wall circumference, greater number of lymph nodes involved, more poorly differentiated cancer, the cancer invading into adjacent organs and ulceroinfiltrative tumor in univariate analysis. The overall five-year survival rate was 53.4% in this series.

並列關鍵字

Colorectal adenocarcinoma ； clinicopathological characteristics ； survival rate

國際替代計量

Clinicopathologic Characteristics in Colorectal Adenocarcinoma and Their Relationship to Survival

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