| [Backround and Objective]Colorectal cancer(CRC)is one of the most common cancers in the worldwide,and it is the fourth leading cause of cancer-related mortality in China.In recent years,due to the influence of factors such as life styles,unfit diet,obesity and environmental factors,the incidence of colorectal cancer in young people increases gradually.The symptoms of these young patients are hidden,so little attention has been paid to them,and thus these young patients are often diagnosed at advanced stages.Therefore,in order to focus on the incidence of CRC,we must pay more attention to the young patients with colorectal tumors in clinical practice.In this report,we conducted a retrospective analysis to explore the clinicopathological characteristics of young patients under 30 years old with CRC,enhance the clinicians’ recognition of CRC in young patients,detect and treat CRC at early stages,and improve the prognosis of these young patients.[Methods]The patients younger than 30 years old who were admitted to Shanghai Changzheng Hospital from Jan 1995 to Dec 2013,diagnosed as CRC,were included in this retrospective study.The baseline characteristics,clinical manifestations and pathological features were collected.All statistical analyses were performed using PASW Statistics version 18.0.Associations between categorical data were analyzed by two-tailed χ2 test and the continuous data were compared by Student’s t test,Data not normally distributed were compared using the Manne Whitney U test.P value less than 0.05 was considered statistically significant.[Results]1.In total,83 patients younger than 30 years old were included in this study.The ageranged from 13 to 30 years old,with the mean age of 26.1 years old.33 patients were male,and 50 were female.2.The duration from the onset of symptoms to diagnosis ranged from 3 days to 24.0 months(average 4.6 months).3.The most common symptoms at diagnosis were bloody stool(55/83,66.3%),change of stool habit(45/83,54.2%)and abdominal pain(35/83,42.2%).4.There were 50 lesions located at rectum(50/83,60.2%),8 lesions at sigmoid colon(8/83,9.6%)and 5 lesions at rectosigmoid junction(5/83,6.0%).5.There were 30 patients with stage Ⅲ(30/81,37.0%)and 29 patients with stage IV(29/81,35.8%).Moreover,there were 39 patients with adenocarcinoma(39/70,55.7%)and 26 with mucinous adenocarcinoma(26/70,37.1%).6.There were 29 patients with metastasis,and 52 without metastasis.More male patients presented with metastasis than the female.There were no differences between the symptoms of patients with and without metastasis.Patients with CRC metastasis complained of more fatigue at diagnosis than their counterparts w:ithout metastasis(31.0%vs.5.8%,P=0.002),but had less pronounced bowel habit change(38.0%vs.65.4%,P=0.017).Additionally,there were differences in lesion locations of the tumors between patients with and without metastasis(P=0.041).Furthermore,there were more mucinous adenocarcinomas in the patients with metastasis(59.1%vs 27.1%).[Conclusion]1.The clinical features of young patients with CRC are diverse and lack of typicality,but the principal manifestations are bloody stool,change of stool habit and abdominal pain.Thus,we must pay more attentions to the related symptoms,and perform rectal examination and colonscopy as soon as possible.2.The CRC in young patients has a worse histological differentiation,higher malignant degree,latter TNM stage and worse prognosis.The early detection and diagnosis of young patients with CRC is very difficult.In order to improve the early diagnosis,we would launch fecal occult blood test survey and perform science popularization,which could lead to the significant improvement on the prognosis of younger CRC patients. |
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