| Objective:To explore the clinical and pathological characteristics of patients with colorectal cancer in cecum in different age groups,and provide references for the diagnosis and treatment of patients with cecal cancer in clinic.Methods:Check the clinical data of 4497 patients with colorectal cancer who were hospitalized for surgical treatment between October 2014 and October 2020 in the Department of Gastrointestinal and Colorectal Surgery,China-Japan Union Hospital of Jilin University,and selected 185 patients with colorectal cancer located in the cecum to be included in the study.The patients were divided into the young and middle-aged group(<60 years old)and the elderly group(≥60 years old),and the clinicopathological characteristics of the two groups were retrospectively compared and analyzed.Results:1.Age and gender: In this study,185 patients with colorectal cancer in the cecum were included.Among the 4497 patients with colorectal cancer who were surgically treated during the same period,it accounted for 4.1%.In the young and middle-aged group,there were 44 males(66.7%)and 22 females(33.3%).The ratio of male to female was 2:1,the average age was(51.62±7.49)years old,and the median age was 54.5 years old.There are 52 males(43.7%)in the elderly group,67females(56.3%),the ratio of male to female is 0.776:1,the average age is(71.30±7.61)years old,and the median age is 71 years old.There was a statistically significant difference in gender composition between the young and middle-aged group and the elderly group(P<0.05).2.Tumor family history and appendectomy history: the proportion of tumor family history and appendectomy history in the young and middle-aged group was slightly higher than that of the elderly group,the difference was not statistically significant(P>0.05).3.Clinical manifestations: The incidence of defecation habits and character changes in the young and middle-aged group was higher than that of the elderly group,and the incidence of abdominal pain/distension and intestinal obstruction was lower than that of the elderly group,the difference was statistically significant(P<0.05).The other clinical manifestations were compared and analyzed,and the difference was not statistically significant(P>0.05).4.Misdiagnosis: Among 185 patients with colorectal cancer in cecum,63 were misdiagnosed as appendicitis,with a misdiagnosis rate of 34.1%.The misdiagnosis rate in the young and middle-aged group(37.9%)was higher than that in the elderly group(31.9%),and the difference was not statistically significant(P>0.05).5.Laboratory indicators: The incidence of anemia in the young and middle-aged group and the high proportion of preoperative tumor markers CEA and CA19-9 were lower than those in the elderly group,and the difference was not statistically significant(P>0.05).6.CT and colonoscopy: Both the young and middle-aged patients and elderly patients underwent CT before operation.The proportion of tumors considered was 92.4% and 94.1%,respectively,and the difference was not statistically significant(P>0.05).Among 185 patients with colorectal cancer in cecum,162 cases(87.6%)underwent colonoscopy before operation,64 cases(97.0%)in the young and middle-aged group,and 98 cases(82.4%)in the elderly group,the difference was statistically significant(P<0.05).Colonoscopy in the young and middle-aged group and the elderly group showed polyp-type lesions in 23.4% and 21.4%,respectively.Tumor-induced intestinal stenosis was 85.9% and 87.8%,respectively,the difference was not statistically significant(P>0.05).7.Surgical methods: The young and middle-aged group and the elderly group were mainly treated with radical surgery,92.4% and 89.1%,respectively,the difference was not statistically significant(P>0.05).8.Pathological characteristics: the young and middle-aged and elderly groups were mainly moderately differentiated adenocarcinoma(57.6%;53.8%),but the difference was not statistically significant(P>0.05).The average maximum diameter of tumors was5.17±2.02 cm and 6.06±2.13 cm in the young and middle-aged group and elderly group respectively.The maximum diameter of the tumor in the young and middle-aged group was smaller than that in the old group,and the difference was statistically significant(P<0.05).In terms of TNM staging,the T stage of the young and middle-aged group and the elderly group are mainly T3 stage.The T3 stage accounts for 69.7% of the young and middle-aged group,and the T3 stage accounts for 78.1% of the elderly group.There was no significant difference in the depth of invasion(T stage),lymphatic metastasis(N stage),and total TNM stage between the young and middle-aged group and the elderly group(P>0.05).Conclusion:1.Colorectal cancer in cecum is more common in young and middle-aged men,and the incidence of changes in bowel habits and traits and colonoscopy are higher in clinically than elderly patients;elderly patients with colorectal cancer in cecum are more common in women,and the tumor diameter is larger than that of young and middle-aged patients.Clinically,the incidence of abdominal pain/distension and intestinal obstruction is higher than that of young and middle-aged patients.2.The young and middle-aged patients and elderly patients with colorectal cancer in cecum are mainly treated by radical surgery.Most of the pathological types are moderately differentiated adenocarcinoma.The depth of tumor invasion is mainly stage T3,and both have a high misdiagnosis rate.Comprehensive auxiliary examinations should be used to confirm the diagnosis and treat in time. |
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