Radical differences in the anatomical distribution of colorectal cancer: a study of differences between American and Chinese patients
Radical differences in the anatomical distribution of colorectal cancer: a study of differences between American and Chinese patients
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DOI：
10.3748/wjg.v9.i4.721
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发表时间：
2003-04-01
影响因子：
4.3
通讯作者：
Wexner, SD
中科院分区：
文献类型：
--
作者：
Qing, SH;Rao, KY;Wexner, SD
目的：比较美国人(白人)和中国(东方人)结直肠癌解剖分布的种族差异，确定年龄、性别和时间与解剖分布的关系。方法：收集1990年至2000年在美国佛罗里达州克利夫兰诊所就诊的690例结直肠癌患者和1990年至2000年在第一军医大学附属南方医院就诊的870例结直肠癌患者的资料。所有患者均经组织学确诊为结直肠腺癌并接受手术治疗。结果：白人和东方人的肿瘤解剖部位分布、年龄和性别差异有统计学意义。近端结肠病变(P<；0.001)在白人患者中为36.3%，在东方人患者中为26.0%，远端结肠和直肠肿瘤在白人患者中为63.7%，在东方人患者中为74%(P<；0.001)。在白人男性中，随着时间的推移，有从远端结肠和直肠到近端结肠的重新分布的趋势，特别是在年龄较大的患者(>；80岁)。白人女性和东方患者的解剖分布没有明显变化。白人患者确诊时的平均年龄为69.0岁，东方患者为48.3岁(P<；0.001)。结论：这是首次对白人和中国人结直肠癌的解剖分布进行比较。美国白人患近侧结直肠癌的风险更高，而且这种风险随着时间的推移而增加。患有结直肠癌的白人男性比例也随着时间的推移而增加。与白人患者相比，中国患者更有可能患有远端结直肠癌，并在显著更早的年龄患上这种疾病。这些发现加深了我们对这两个种族结直肠癌发病过程的理解。
AIM: To compare the racial differences of anatomical distribution of colorectal cancer (CRC) and determine the association of age, gender and time with anatomical distribution between patients from America (white) and China (oriental).METHODS: Data was collected from 690 consecutive patients in Cleveland Clinic Florida, U.S.A. and 870 consecutive patients in Nan Fang Hospital affiliated to the First Military Medical University, China over the past 11 years from 1990 to 2000. All patients had colorectal adenocarcinoma diagnosed by histology and underwent surgery.RESULTS: The anatomical subsite distribution of tumor, age and gender were significantly different between white and oriental patients. Lesions in the proximal colon (P < 0.001) were found in 36.3% of white vs 26.0% of oriental patients and cancers located in the distal colon and rectum in 63.7% of white and 74% of oriental patients (P < 0.001). There was a trend towards the redistribution from distal colon and rectum to proximal colon in white males over time, especially in older patients (> 80 years). No significant change of anatomical distribution occurred in white women and Oriental patients. The mean age at diagnosis was 69.0 years in white patients and 48.3 years in Oriental patients (P < 0.001).CONCLUSION: This is the first study comparing the anatomical distribution of colorectal cancers in whites and Chinese patients. White Americans have a higher risk of proximal CRC and this risk increased with time. The proportion of white males with CRC also increased with time. Chinese patients were more likely to have distal CRC and developed the disease at a significantly earlier age than white patients. These findings have enhanced our understanding of the disease process of colorectal cancer in these two races.