Clinicopathological characteristics and treatment of multiple primary colorectal carcinoma

中华消化内镜杂志 Pub Date : 2019-10-20 DOI:10.3760/CMA.J.ISSN.1007-5232.2019.10.004

Chunmei Guo, Jing Wu, Hong Liu, Yadan Wang

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引用次数: 0

Abstract

Objective To investigate clinicopathological characteristics, diagnosis and treatment of multiple primary colorectal carcinoma (MPCC). Methods From January 2008 to March 2017, 42 patients diagnosed with MPCC underwent surgery at Beijing Shijitan Hospital, Capital Medical University. Their clinicopathological features, diagnosis and treatment were analyzed. Results These 42 MPCC patients accounted for 7.1% (42/592) colorectal cancer patients in the same period. There were 64 intestinal cancer lesions in 32 patients (76.2%) with synchronous carcinoma (SC), and 20 intestinal cancer lesions in 10 patients (23.8%) with metachronous carcinoma(MC), where the interval between the first and the recurrent was 18-105 months. The proportion of patients in the SC group with highly to moderately differentiated adenocarcinoma was significantly higher compared with that of the MC group (P 0.05). Among 42 patients undergoing radical operation, 6 received colonic metallic stent implantation as a bridge to elective resection in 10 patients with colonic obstruction. Conclusion MPCC, mainly two-lesion cancer, is most commonly found in sigmoid colon and rectum. Those with poorly differentiated cancer, mucinous carcinoma and those complicated with adenoma should be closely followed up with colonoscopy. Colonic metallic stent implantation as a bridge to elective resection may improve the detection rate of SC. Key words: Colorectal neoplasms; Neoplasms, multiple primary; DNA mismatch repair; Synchronous carcinoma; Metachronous carcinoma

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多原发性结直肠癌的临床病理特点及治疗

目的探讨多发原发结直肠癌(MPCC)的临床病理特点、诊断及治疗方法。方法2008年1月至2017年3月，首都医科大学附属北京世纪坛医院42例确诊为MPCC的患者行手术治疗。分析其临床病理特点、诊断及治疗方法。结果42例MPCC患者占同期结直肠癌患者的7.1%(42/592)。同步癌(SC) 32例(76.2%)发生64个肠癌灶，异时性癌(MC) 10例(23.8%)发生20个肠癌灶，首次发病与复发的时间间隔为18 ~ 105个月。SC组高分化至中分化腺癌患者比例明显高于MC组(P < 0.05)。42例根治性手术患者中，10例结肠梗阻患者中6例行结肠金属支架置入术，作为择期切除的桥梁。结论乙状结肠、直肠多见，以双病变为主。低分化癌、粘液癌及合并腺瘤者应密切随访结肠镜检查。结肠金属支架植入术作为选择性切除的桥梁可提高SC的检出率。关键词:结直肠肿瘤;肿瘤，多发原发;DNA错配修复;同步癌;Metachronous癌

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来源期刊

中华消化内镜杂志

CiteScore

0.10

自引率

0.00%

发文量

7555

期刊介绍： Chinese Journal of Digestive Endoscopy is a high-level medical academic journal specializing in digestive endoscopy, which was renamed Chinese Journal of Digestive Endoscopy in August 1996 from Endoscopy. Chinese Journal of Digestive Endoscopy mainly reports the leading scientific research results of esophagoscopy, gastroscopy, duodenoscopy, choledochoscopy, laparoscopy, colorectoscopy, small enteroscopy, sigmoidoscopy, etc. and the progress of their equipments and technologies at home and abroad, as well as the clinical diagnosis and treatment experience. The main columns are: treatises, abstracts of treatises, clinical reports, technical exchanges, special case reports and endoscopic complications. The target readers are digestive system diseases and digestive endoscopy workers who are engaged in medical treatment, teaching and scientific research. Chinese Journal of Digestive Endoscopy has been indexed by ISTIC, PKU, CSAD, WPRIM.