| Objective: To study clinical characteristics of patients with colorectal cancer (CRC) and their variation trends in Dalian area.Methods: 582 patients with CRC proven by histopathological examination were enrolled from January, 2002 to December, 2006 in this study. We analyzed retrospectively clinical characteristics of all patients including mean age of episode, location, type of histopathology, clinical nature, and Dukes′stage of tumor, postoperative surveilance. Based on age of episode, the patients were divided into the following groups: < 29, 30-39, 40-49, 50-59, 60-69, 70-79, and > 80 years of age. The pathological types of CRC were composed of adenocarcinoma, mucoadenocarcinoma, signet-ring cell carcinoma, and other types. The location of involvement in CRC included rectum, sigmoid colon, ascending colon, hepatic flexure, transverse colon, spleen flexure, descending colon, ileocecum.Results:(1) The average age diagnosed of totally 582 patients was 66 years old. Colorectal cancer often occurs in ages from 60 to 79 years old (P<0.05). There has been a steady increase in highly differentiated adenocarcinoma and decrease in poorly differentiated adenocarcinoma with age (P<0.05).(2) Rectum was the most common location of involvement in CRC, which acounted for 56.01 percent. Comparing the clinical characteristics of annual prevalence, there was no significant difference (P>0.05) among the location of tumor involvment.(3) Moderately differentiated adenocarcinoma was observed in 58.22 percent.From the pathological viewpoint, the proportions of poor differentiated adenocarcinoma were increased, while those of mucinous adenocarcinoma were decreased.(4) The most common clinical symptoms of colorectal cancer were irregular bowel movement, hematochezia, or abdominal pain. Hematochezia was likely to occur with rectal cancer. 170 patients with CRC were accompanied with polypus, of which 64 were adenomas. Villous adenoma had the highest malignant tendency, tubulovillous adenoma next, and tubular adenoma had the lowest. CRC were often accompanied with some diseases such as diabetes mellitus, cholecystolithiasis, chronic appendicitis.(5) 72 of 582 patients died during the observation period. Survival period ranged from ten days to four and a half years. The premier causes of death were acute respiratory and circulation failure. Recurrence was detected in a 1-year follow-up surgical operation period. Patients with tumor metastasis often had one year survival period. The most common metastatic sites was the liver.(6) The patients with Dukes′A stage stood at only 6.18 percent of all CRC, while patients with progressing stages (B, C, D stages) made up 93.81 percent. The increased serum levels of CEA in CRC were in step with the Dukes′stage progress (P<0.05). nm23 and Topo-II appear obviously correlation to degree of histological differentiation.Conclusions:(1) Colorectal cancer often occurs in ages from 60 to 79 years old. Highly differentiated adenocarcinoma is increased with age, while poorly differentiated adenocarcinoma is decreased. The proportion of poor differentiated adenocarcinoma is increased and mucinous adenocarcinoma is decreased in recent five years.(2) Adenoma is a very important precancerous lesion. Some diseases such as diabetes, cholecystolithiasis, chronic appendicitis have possible relations- hips with the colorectal cancer.(3) Relapse and metastasis are the main factors responsible for prognosis. CEA has a close relation with Dukes′stage progress.(4) Nm23 and Topo-II are immunohistochemical indicators related to degree of histological differentiation. |
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