Predictors of proximal vs. distal colorectal cancers
Predictors of proximal vs. distal colorectal cancers
复制标题
DOI：
10.1007/bf02234301
复制
发表时间：
2001-02-01
影响因子：
3.9
通讯作者：
Campbell, R
中科院分区：
文献类型：
--
作者：
Gonzalez, EC;Roetzheim, RG;Campbell, R
背景：由于近端结直肠癌往往处于较晚期，因此预后较差，因此了解与近端结直肠癌发生发展相关的因素是很重要的。我们假设高龄、女性和合并疾病的存在bt：与近端癌症有关。方法：1994年发生的9,550例结直肠癌病例来自佛罗里达州以人口为基础的全州癌症登记。我们将结直肠癌分为近端(盲肠、升结肠和横结肠)或远端(降结肠、乙状结肠、直肠乙状结肠和直肠)。多因素Logistic回归分析用于确定临床特征和近端病变发生几率之间的多变量关系。结果：四个特征作为近端病变的独立预测因子出现。每个人。年龄增长的年份与患近端病变的几率增加2.2%有关，而女性与患近端病变的几率增加38%有关。并存疾病的存在与近端病变的几率增加28%有关，最后，非西班牙裔黑人与近端病变的几率增加24%相关。结论：我们发现，年龄增加、女性、黑人、非西班牙裔种族和合并疾病的存在与近端发生结直肠癌的可能性更大相关。还需要进一步的研究来证实这些发现，并建立共病影响结直肠癌发生部位的机制。
BACKGROUND: Because proximal colorectal cancers have a tendency to present at a more advanced stage and thus have a poorer prognosis, it is important to understand the factors associated with the development of proximal colorectal cancer. We hypothesized that older age, female gen der, and the presence of comorbid illness would bt: associated with proximal cancers. METHODS: Incident cases of colorectal cancer (n = 9,550) occurring in 1994 were identified from Florida's population-based statewide cancer registry. We categorized colorectal cancers as either proximal (cecum, ascending colon, and transverse colon) or distal (descending colon, sigmoid colon, rectosigmoid, and rectum). Multiple logistic regression analysis was used to determine the multivariable relationship between clinical characteristics and the odds of a proximal-occurring lesion. RESULTS: Four characteristics emerged as independent predictors of a proximal lesion. Each. year of increasing age was associated with a 2.2 percent increase in the odds of a proximal lesion, whereas female gender was associated with a 38 percent increase in the odds of a proximal lesion. The presence of a comorbid condition was associated with a 28 percent greater odds of a proximal lesion, and, finally, black, non-Hispanic race was associated with a 24 percent greater odds of a proximal lesion. CONCLUSIONS: We found that increasing age, female gender, black, non-Hispanic race, and the presence of comorbid illnesses were factors associated with a greater likelihood of developing colorectal cancer in a proximal location. Further studies will be required to confirm these findings and to establish the mechanism by which comorbidity influences the site of colorectal cancer development.