目的 探讨同时性双原发与单原发结直肠癌患者临床特征及预后。 方法 回顾性病例系列研究。回顾性分析2015年1月至2018年1月就诊于山西省肿瘤医院的45例同时性双原发结直肠癌及53例单原发结肠癌、59例单原发直肠癌患者的临床资料，包括性别、年龄、饮酒史、吸烟史、体质量指数（BMI）、癌胚抗原（CEA）、糖类抗原199（CA199）、血红蛋白、清蛋白、TNM分期，比较3组患者的临床病理特征。采用Kaplan-Meier法进行生存分析，比较3组患者的总生存情况。 结果 同时性双原发结直肠癌患者中男性28例，女性17例，年龄（63±11）岁；单原发结肠癌患者中男性30例，女性23例，年龄（61±12）岁；单原发直肠癌患者中男性30例，女性29例，年龄（60±11）岁。双原发癌与单原发结肠癌患者BMI差异有统计学意义（P＝0.041），而性别、年龄、饮酒史、吸烟史、CEA、CA199、贫血、低蛋白血症及TNM分期差异均无统计学意义（均P>0.05）。双原发癌与单原发直肠癌患者BMI、CEA及CA199差异均有统计学意义（均P<0.05），而性别、年龄、饮酒史、吸烟史、血红蛋白、清蛋白及TNM分期差异均无统计学意义（均P>0.05）。1、3、5年总生存率双原发癌患者分别为95.56%、77.78%、62.22%，单原发结肠癌患者分别为94.34%、81.13%、69.81%，单原发直肠癌患者分别为100%、88.14%、72.88%，双原发癌患者与单原发结肠癌、直肠癌患者总生存差异均无统计学意义（均P>0.05）。 结论 BMI异常升高可能与同时性双原发结直肠癌的发生有关。CEA、CA199检测有助于监测直肠癌患者是否合并其他原发肿瘤。单原发结肠癌或直肠癌患者预后与同时性双原发结直肠癌患者相当。 Objective To explore the clinical features and prognosis of simultaneous double primary and single primary colorectal cancer patients. Methods A retrospective case series study was conducted. The clinical data of 45 patients with simultaneous double primary colorectal cancer, 53 patients with single primary colon cancer and 59 patients with single primary rectal cancer in Shanxi Province Cancer Hospital from January 2015 to January 2018 were retrospectively analyzed, including gender, age, drinking history, smoking history, body mass index (BMI), carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), hemoglobin, albumin, TNM stage. The clinicopathological characteristics of the three groups were compared. Survival analysis was performed using the Kaplan-Meier method to compare the overall survival of the three groups. Results The age of simultaneous double primary colorectal cancer patients was (63±11) years old, including 28 males and 17 females the age of single primary colon cancer patients was (61±12) years old, including 30 males and 23 females the age of single primary rectal cancer patients was (60±11) years old, including 30 males and 29 females. There was a significant difference in BMI between patients with double primary cancer and single primary colon cancer (P = 0.041), but there were no significant differences in gender, age, drinking history, smoking history, CEA, CA199, hemoglobin, albumin and TNM stage (all P > 0.05). There were significant differences in BMI, CEA and CA199 between patients with double primary cancer and single primary rectal cancer (all P < 0.05), but there were no significant differences in gender, age, drinking history, smoking history, hemoglobin, albumin and TNM stage (all P > 0.05). The 1-, 3- and 5-year overall survival rates of the double primary cancer patients were 95.56%, 77.78% and 62.22%, the single primary colon cancer patients were 94.34%, 81.13% and 69.81%, and the single primary rectal cancer patients were 100.00%, 88.14% and 72.88%, respectively. There was no significant difference in OS among patients with double primary cancer, single primary rectal cancer and single primary rectal cancer (both P > 0.05). Conclusions Abnormally elevated BMI may be associated with the risk of developing simultaneous double primary colorectal cancer. Detection of CEA and CA199 is helpful in monitoring rectal cancer patients for the combination of other primary tumors. The prognosis of patients with single primary colon or rectal cancer is comparable to that of patients with simultaneous double primary colorectal cancer.
Abstract
Objective To explore the clinical features and prognosis of simultaneous double primary and single primary colorectal cancer patients. Methods A retrospective case series study was conducted. The clinical data of 45 patients with simultaneous double primary colorectal cancer, 53 patients with single primary colon cancer and 59 patients with single primary rectal cancer in Shanxi Province Cancer Hospital from January 2015 to January 2018 were retrospectively analyzed, including gender, age, drinking history, smoking history, body mass index (BMI), carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), hemoglobin, albumin, TNM stage. The clinicopathological characteristics of the three groups were compared. Survival analysis was performed using the Kaplan-Meier method to compare the overall survival of the three groups. Results The age of simultaneous double primary colorectal cancer patients was (63±11) years old, including 28 males and 17 females the age of single primary colon cancer patients was (61±12) years old, including 30 males and 23 females the age of single primary rectal cancer patients was (60±11) years old, including 30 males and 29 females. There was a significant difference in BMI between patients with double primary cancer and single primary colon cancer (P = 0.041), but there were no significant differences in gender, age, drinking history, smoking history, CEA, CA199, hemoglobin, albumin and TNM stage (all P > 0.05). There were significant differences in BMI, CEA and CA199 between patients with double primary cancer and single primary rectal cancer (all P < 0.05), but there were no significant differences in gender, age, drinking history, smoking history, hemoglobin, albumin and TNM stage (all P > 0.05). The 1-, 3- and 5-year overall survival rates of the double primary cancer patients were 95.56%, 77.78% and 62.22%, the single primary colon cancer patients were 94.34%, 81.13% and 69.81%, and the single primary rectal cancer patients were 100.00%, 88.14% and 72.88%, respectively. There was no significant difference in OS among patients with double primary cancer, single primary rectal cancer and single primary rectal cancer (both P > 0.05). Conclusions Abnormally elevated BMI may be associated with the risk of developing simultaneous double primary colorectal cancer. Detection of CEA and CA199 is helpful in monitoring rectal cancer patients for the combination of other primary tumors. The prognosis of patients with single primary colon or rectal cancer is comparable to that of patients with simultaneous double primary colorectal cancer.
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