| BackgroundColorectal cancer is a common malignant tumor in China.According to statistics,the incidence and mortality of colorectal cancer are on the rise in China.Colorectal cancer ranks 4th in the incidence of malignant tumors and 5th in the mortality rate in China.Although the 5-year relative survival rate of colorectal cancer in China has increased compared with the past,there are still many gaps,mainly due to the relatively low rate of early diagnosis of colorectal cancer in China.Therefore,early detection and diagnosis of colorectal cancer is very important to improve the survival rate of colorectal cancer patients.The incidence of colorectal cancer in China increases rapidly after the age of 25,while the mortality rate increases rapidly after the age of 30.The majority of colorectal cancer patients in China are middle-aged and elderly,but the incidence of colorectal cancer in young people in China is also high.Therefore,screening awareness of middle-aged and elderly people should be improved,and attention should be paid to young people,so as to achieve early diagnosis and early treatment of colorectal cancer and reduce the mortality rate of colorectal cancer patients.At present,most studies on colorectal cancer focus on the treatment of colorectal cancer.This study focused on the analysis of the characteristics of colorectal cancer,and conducted age stratification according to the colorectal cancer screening guidelines in recent years in China,and statistically analyzed the clinical and pathological characteristics of colorectal cancer patients in different age groups.ObjectiveThis study aimed to colorectal cancer patients of different ages of clinical manifestation,laboratory examination and histologic features of summary analysis,understand the characteristics of the different age patients with colorectal cancer clinical and pathological characteristics of orientation and differences,so as to strengthen the monitoring of people aged colorectal cancer screening,improve the relevant clinical characteristics of young people consciousness of colorectal cancer screening,In order to improve the survival rate of patients with colorectal cancer in China,reduce the mortality of patients with colorectal cancer.Research objects and methodsInpatients with colorectal cancer diagnosed by colonoscopy in Qilu Hospital of Shandong University from July 2017 to June 2020 were selected to retrospectively collect their clinical data,including demographic characteristics,clinical symptoms,past medical history and family history,laboratory examination results,colonoscopy results,pathological results,etc.Statistical analysis was conducted according to different age groups(<40 years old,40-50 years old,and>50 years old).Results1.After screening,a total of 850 patients with colorectal cancer were included in this study,with a male to female ratio of 1.4:1 and an age range of 15-90 years,with an average age of 61.74±12.41 years.The most common clinical symptom was bloody stools or melena(62.24%,529/850),and 50 patients did not show any clinical symptoms.Hypertension(32.71%,278/850)was the most common accompanying medical history,with 401 patients without any prior or family history.The most common laboratory tests were HGB and ALB,and 848 patients were tested for HGB and ALB,with a positive rate of 36.79%and 30.66%,respectively,and 598 patients were tested for OB,with a positive rate of 85.45%.The detection rates of CEA,CA199,CA125 and CA724 were 96.00%,95.41%,93.65%and 85.65%,respec tively.The tumor marker with the highest positive rate was CEA,with a positive rate of 42.28%.Rectum(51.88%,441/850)was the most common site,with 817 single lesions.Ulcerative type(54.59%,464/850)was the most common gross phenotype,the most common pathological type was adenocarcinoma,non-specific type(81.41%,692/850),and the most common grade of lesion differentiation was medium differentiation(52.35%,445/850).Among all the patients,69 cases were accompanied by cancer nodules,and the pathological staging was mainly advanced tumors of stage C and D(81.16%,56/69).The most common pathological staging of colorectal cancer patients was Dukes stage C(30.12%,256/850),and Dukes stage A+B was roughly equivalent to stage C+D.The ratio of stage A+B to stage C+D was about 1.08:1.2.A total of 40 patients(4.7%,40/850)with age<40 years old were diagnosed with colorectal cancer,and the male to female ratio was 1.7:1.The youngest age was 15 years old,and the mean age was 31.25±6.14 years old.The most common clinical symptom was bloody stools or melena(62.50%,25/40),and all patients presented clinical symptoms.Most of the patients did not have concomitant diseases or previous medical history(72.50%,29/40).All patients were tested for HGB and ALB,and the positive rate was 50%and 32.50%,respectively.A total of 29 patients were tested for OB,and the positive rate was 86.21%.The positive rate of CEA,CA125 and CA199 were all 95.00%,and the positive rate of CA724 was 77.50%.The positive rate was 48.39%.Rectum(52.50%,21/40)was the most common site,and all patients had a single lesion.Ulcerative type(40.00%,16/40)was the most common gross phenotype,the most common pathological type was adenocarcinoma,non-specific type(72.50%,29/40),and the most common grade of lesion differentiation was medium differentiation(37.50%,15/40).The most common pathological stage of patients was Dukes stage D(45.00%,18/40),and the ratio of Dukes stage A+B to C+D was 0.54:1.3.A total of 108 patients(12.7%,108/850)aged 40-50 years with a male-to-female ratio of 1.7:1 and a mean age of 45.84±2.89 years were diagnosed with colorectal cancer.The most common clinical symptom was bloody stools or melena(70.37%,76/108).Hypertension(15.74%,17/108)was the most common accompanying medical history,and most patients(68.52%,74/108)did not have any previous or family history.All patients were tested for HGB and ALB,and the positive rates were 38.89%and 21.30%,respectively.A total of 71 patients were tested for OB,and the positive rates were 87.32%.The detection rates of CEA and CA199 were 94.44%,the detection rates of CA125 were 92.59%,and the detection rates of CA724 were 83.33%.The highest positive rate of tumor markers was CEA,with a positive rate of 39.22%.Rectum(48.14%,52/108)was the most common site of disease,and the majority of patients had a single lesion(97.22%,105/108).Ulcerative type(54.63%,59/108)was the most common gross phenotype,the most common pathological type was adenocarcinoma,non-specific type(75.93%,82/108),and the most common grade of lesion differentiation was medium differentiation(50.00%,54/108).The most common pathological stage of patients was Dukes stage B(30.56%,33/108),and the ratio of Dukes stage A+B to C+D was 0.93:1.4.There were 702 colorectal cancer patients(82.6%,702/850)with age>50 years old,the male to female ratio was 1.3:1,and the mean age was 65.92±8.58 years old.The most common clinical symptom was bloody stools or melena(60.97%,428/702).46 patients did not show any clinical symptoms.Hypertension(37.04%,260/702)was the most common accompanying medical history,and 298 patients had no prior or family history.The most common laboratory tests were HGB and ALB,with positive rates of 35.71%and 32.00%in 700 patients and 85.14%for OB in 498 patients.The detection rates of CEA,CA199,CA125 and CA724 were 96.30%,95.58%,93.73%and 86.47%,respectively.The tumor marker with the highest positive rate was CEA,with a positive rate of 43.20%.Rectum(52.42%,368/702)was the most common site,with 672 cases of single lesions.Ulcerative type(55.41%,389/702)was the most common gross phenotype,the most common pathological type was adenocarcinoma,non-specific type(82.76%,581/702),and the most common lesion differentiation grade was moderately differentiated(53.56%,376/702).The most common pathological stage of colorectal cancer patients was Dukes stage C(31,05%,218/702),and the ratio of Dukes stage A+B to C+D was 1.15:1.5.All patients in the group younger than 40 years old had clinical symptoms,4 patients in the group 40-50 years old had no clinical symptoms,and 46 patients in the group older than 50 years old had no clinical symptoms.Pair comparison between the three groups showed P values greater than 0.05,and the difference was not statistically significant.The pathological stages of the group younger than 40 years old were compared with those of the group older than 50 years old.The P value was 0.023,and the difference was statistically significant.Conclusion1.The incidence of colorectal cancer is more male than female,and the incidence population is mainly middle-aged and elderly.For the occurrence of blood stool or black stool patients to be alert to the possibility of colorectal cancer.Young patients are often symptomatic,and attention should be paid to young patients with persistent symptoms.Some middle-aged and elderly patients do not show any clinical symptoms,so it is necessary to improve the awareness of colorectal cancer screening in middle-aged and elderly people.2.OB is cost-effective in colorectal cancer screening,and the detection rate in the population should be further improved.CEA,CA724 and other tumor markers can be used as reference indexes.3.Young colorectal cancers tend to be advanced tumors of stage C and D,and more attention should be paid to the young population. |
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