| BackgroundColorectal cancer(CRC)is one of the most common malignant tumors.The incidence of colon cancer in China is increasing.The incidence of men and women has little difference.The age of onset is rising from the age of 50.The age of the disease is more than 40-60 years old in our country.The young type of colorectal cancer under 20 years old is not uncommon.The most common location is rectum,followed by sigmoid colon.The incidence of colorectal cancer is very different in different regions,relatively low in Africa,Japan,and in Western Europe,North America and New Zealand.Although China belongs to the low incidence region of colorectal cancer,the incidence of colorectal cancer in China is rising in recent years,including Shanghai,Zhejiang,Fujian and so on.The ground is a high incidence area.The pathogenesis is closely related to genetic factors,environmental factors and dietary factors.The incidence of colorectal cancer in patients with chronic colitis is significantly higher than that of the general population,and the cancer rate of the patients with ulcerative colitis is about 5%,and the incidence of colorectal cancer is higher in the patients with familial polyposis.With the improvement of living standard,the change of high fat,low cellulose diet structure and a large number of nitrosamines make the incidence of colorectal cancer increasing year by year.Early colorectal cancer has no obvious symptoms,but it will progressively lose weight,abdominal pain,defecation habit change and bloody stool with the progress of the disease.Colorectal signet ring cell carcinoma(SRCC)is a special classification of colonic mucinous adenocarcinoma.Its pathological differentiation,high degree of malignancy and increasing incidence are serious threats to the life and health of patients with colorectal signet ring cell carcinoma.Clinicians are concerned about the awareness,early diagnosis,effective treatment and prognosis of colorectal signet ring cell carcinoma and colorectal adenocarcinoma.How do we compare colorectal signet ring cell carcinoma and colorectal adenocarcinoma in clinic? ObjectiveTo analyze and compare the clinical features of colorectal signet-ring cell carcinoma and colorectal adenocarcinoma and endoscopic performance.MethodsThe clinical data of forty nine patients with Colorectal signet-ring cell carcinoma and one hundred patients with colorectal adenocarcinoma admitted to the First Affiliated Hospital of Zhengzhou University from September of 2010 to September of 2013 were retrospectively analyzed.The clinical features and endoscopic findings were compared.Using SPSS 20.0 for data analysis,P<0.05 was statistically significant.Results(1)Age: the age of the colorectal signet ring cell carcinoma group was 61.2%(30/49),the average age was(45.2±5.6)years and 32.0%(32/100)in the adenocarcinoma group less than 45 years old,and the average age was(52.3±8.2)years old.The mean age of the signet ring cell carcinoma group was younger than that of the adenocarcinoma group(t=8.673,P = 0.032).(2)The distribution of tumor site: 9 cases of left semicolon in colorectal signet ring cell carcinoma group,18.4%(9/49),22 cases of right colon,44.9%(22/49),18 rectum,36.8%(18/49).In the colorectal adenocarcinoma group,32 cases were located in the left half colon,accounting for 32.0%(32/100),26 cases in the right colon,26.0%(26/100),and 42 cases in rectum,accounting for 42.0%(42/100).The proportion of the right hemi colon in the colorectal cancer group was significantly higher in all patients with colorectal cancer than in other patients.The difference was statistically significant(P<0.05).(3)Incidence of lymph node invasion and vascular metastasis: 91.8%(45/49)of lymph node invasion in signet ring cell carcinoma group and 73.0%(73/100)of adenocarcinoma group with lymph node invasion,73.0%(73/100)of signet ring cell carcinoma group was higher than that in adenocarcinoma group;the incidence of blood vessel metastasis in signet ring cell carcinoma group was 61.2%(30/45);The incidence of metastasis was 40.0%(40/100),and the incidence of vascular metastasis in the signet ring cell carcinoma group was higher than that in the adenocarcinoma group.In the signet ring cell cancer group,91.8%(45/49)of T3 and T4 patients were significantly more than that of the adenocarcinoma group 73.0%(73/100),and the invasion depth of the signet ring cell carcinoma group was deeper than that of the adenocarcinoma group.In the signet ring cell cancer group,the lymph node invasion,the rate of vascular metastasis and the depth of invasion were all higher than those in the adenocarcinoma group,the difference was statistically significant(P<0.05).(4)The incidence of intestinal obstruction,the number of radical mastectomy,the survival rate: the incidence of intestinal obstruction in the signet ring cell carcinoma group was 24.5%(12/45);the adenocarcinoma combination and the incidence of intestinal obstruction accounted for 10.0%(10/100);the proportion of signet ring cell carcinoma and the incidence of intestinal obstruction was higher than that of the adenocarcinoma group;the number of patients in the signet ring cell carcinoma group underwent radical mastectomy 61.2%(30/45),83.0%(83/100)in adenocarcinoma group,the number of signet ring cell carcinoma group was lower than that of adenocarcinoma group;the 1,3,5 years survival rate of the signet ring cell carcinoma group was 67.3%,49%,26.5%,and the 1,3,5 year survival rate of adenocarcinoma patients was 87.0%,71.0%,62.0%.At the end of the follow-up,nearly 46% of the patients with adenocarcinoma survived.The incidence of intestinal obstruction in the signet ring cell carcinoma group was more than that in the adenocarcinoma group,and the number of cases in the radical operation and the survival rate of the signet ring cell carcinoma group were lower than that of the adenocarcinoma group,the difference was statistically significant(P<0.05).(5)Endoscopy and pathology: the pathology of signet ring cell carcinoma group was 8cm×5.2cm×3.8cm and the mean diameter was(6.1±2.0)cm.The maximum diameter of colon adenocarcinoma group was 7.1cm×4.5cm×1.7cm,with an average diameter of(4.5 ± 1.2)cm.The mean diameter of tumor pathology in signet ring cell carcinoma group was larger than that in colon adenocarcinoma group(t=9.233,P=0.023).The classification of colonoscopy in the signet ring cell carcinoma group is 12 cases,10 cases of ulceration,21 cases of infiltrative type.Conclusion(1)The age of the colorectal cancer signet ring cell carcinoma group was less than that of the adenocarcinoma group,the incidence of right hemi colon,the incidence of lymph node invasion and vascular metastasis and the incidence of intestinal obstruction were higher than those in the adenocarcinoma group,and the depth of infiltration was greater than that of the adenocarcinoma group,and the number of radical mastectomy was less than that of the adenocarcinoma group.(2)Survival rate of signet ring cell carcinoma in colorectal cancer was lower than that in adenocarcinoma group.(3)Signet ring cell carcinoma showed no specificity under endoscopy,and infiltrative type was the most common. |
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