| Objective:Through collecting and analyzing relevant clinical data,the clinicopathological features and operative results of colorectal cancer patients aged over 75 years old are discussed to provide data support for clinical diagnosis and prevention of colorectal cancer in elderly patients.Materials and methods:A total of 158 elderly patients with colorectal cancer aged 70 and over who were treated in the Department of Gastroenterology and Rectal Surgery,China-Japanese Friendship Hospital,Jilin University from January 2012 to December 2016 were selected retrospectively as study subjects.85 cases of colon cancer,73 cases of rectal cancer.All patients with complete case information,colonoscopy or postoperative pathology clear diagnosis.According to age,patients were divided into the elderly group(70 years-79 years old),super-aged group(?80 years old).The gender,family history,clinical manifestations,comorbidities,laboratory tests,tumor pathological features,surgical methods,postoperative complications and perioperative mortality were collected and analyzed statistically using SPSS 22.0 statistical software X2 test,P <0.05 means that the difference was statistically significant.Results:(1)Gender: Of the 158 patients,90 were male patients and 68 were female patients,with a male to female ratio of 1.32: 1.Men had a higher incidence than women.There was no significant difference in gender composition between the two age groups(P> 0.05).There was no statistical significance.(2)Clinical Symptoms: The clinical symptoms in both age groups were mainly changed with defecation habits(constipation and diarrhea)and changes in stool characteristics(bloody stools,mucus bloody stools and blood stools).The elderly group had 59.38% changes in stool traits,45.74% in the ultra-aged group,and the difference between the two groups was statistically significant(P <0.05).The older group had abdominal distension of 37.50% and ultra-aged group of 16.13%(P <0.05).Preoperative bowel obstruction symptoms were 26.04% in advanced age group and 45.16% in ultra-advanced age group,with significant difference between the two groups(P <0.05).The incidence of abdominal mass in the elderly group was 8.33%,which was lower than that in the super-aged group(24.19%).There was statistical significance between the two groups(P <0.05).Other clinical symptoms were no difference between the two groups,no statistical significance(P> 0.05).(3)Family history: Family history was no significant difference between the two groups(P> 0.05).(4)Tumor location: There was no significant difference in tumor location between the two age groups(P> 0.05).There was significant difference between male and female in tumor location(P <0.05).(5)General types and sizes of tumors: The general types of tumors in both groups were more prominent in bulge type and ulcer type.The size of tumor was more than or equal to 4cm.There was no significant difference between the two groups(P> 0.05).(6)The tumor marker CEA: CEA?5?g / L was more common in both age groups,no difference,no statistical significance(P> 0.05).(7)Histological type: The incidence of differentiated adenocarcinoma in the advanced age group was higher than that in the ultra-aged age group,and there was significant difference between the two groups(P <0.05).The incidence of well-differentiated adenocarcinoma in the ultra-advanced age group was higher than that in the advanced age group There was a significant difference between the two groups(P <0.05).The incidence of poorly differentiated adenocarcinoma in both age groups was similar,with no significant difference between the two groups(P> 0.05).(8)Clinical stage: The TNM stage of advanced age group and ultra-advanced age group were mainly in stage II and III.There was no significant difference between the two groups(P> 0.05).(9)Comorbidity: Compared with preoperative comorbidities of common senior citizens and senior citizens,both hypertension and lung diseases are the main types,with 1-2 kinds of comorbidities,with no significant difference between the two groups(P> 0.05).(10)The operative correlation: There was no significant difference in the prognostic nutritional index between the two age groups(P> 0.05).There was no significant difference in ASA scores between the two age groups(P> 0.05).There was a statistically significant difference between the two groups in the operative rate of the elderly group(P <0.05).There was no significant difference in the postoperative complications between the two groups,and no significant difference was found between the two groups Statistical significance(P> 0.05).conclusion:(1)The elderly and ultra-advanced colorectal cancer early diagnosis is not easy;easy to misdiagnosis;with age,increased intestinal obstruction,emergency surgery and more.(2)The pathological differentiation of advanced and ultra-advanced colorectal cancer is mainly differentiated and well-differentiated,with low malignant degree and high resection rate.(3)Surgical treatment is an effective method for the treatment of elderly and super-aged patients with colorectal cancer.Perioperative preoperative treatment,can reduce the risk of complications and perioperative mortality. |
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