COLORECTAL-CARCINOMA ASSOCIATED WITH ULCERATIVE-COLITIS - A STUDY OF PROGNOSTIC INDICATORS
COLORECTAL-CARCINOMA ASSOCIATED WITH ULCERATIVE-COLITIS - A STUDY OF PROGNOSTIC INDICATORS
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DOI：
10.1016/s0002-9610(05)80638-5
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发表时间：
1992-07-01
影响因子：
3
通讯作者：
GREENSTEIN, AJ
中科院分区：
文献类型：
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作者：
HEIMANN, TM;OH, SC;GREENSTEIN, AJ
对1973年至1988年在西奈山医院行结肠切除术的52例溃疡性结肠炎和结直肠癌患者进行了回顾性研究，以确定年龄、性别、结肠炎病程、肿瘤部位、癌个数、肿瘤分化程度、胶体含量、印戒细胞的存在、Dukes‘s分级和DNA倍体与生存的关系。平均年龄为45岁，结肠炎的平均病程为21年。Dukes‘A期5例(10%)，Dukes’B期17例(33%)，Dukes‘C期17例(33%)，远处转移13例(25%)。30名患者(58%)为高分化或中分化肿瘤，而22名患者(42%)为低分化肿瘤。28例患者(54%)有胶质瘤，14例(27%)有印戒细胞。非二倍体肿瘤31例(60%)。精算分析显示，非二倍体肿瘤患者的5年存活率显著低于非二倍体肿瘤患者(76%比32%)。当按分期分层时，只有Dukes‘C病变的患者在二倍体肿瘤和非二倍体肿瘤的存活率上有显著差异。多因素分析显示Dukes‘s分级是最好的预后指标，其次是肿瘤分化程度和DNA倍体。肿瘤部位、胶体含量、癌数目、病程、年龄和性别与预后无关。
Fifty-two patients with ulcerative colitis and colorectal cancer undergoing colectomy at the Mount Sinai Hospital between 1973 and 1988 were studied retrospectively to determine the correlation of age, sex, duration of colitis, tumor location, number of cancers, tumor differentiation, colloid content, presence of signet ring cells, Dukes' classification, and DNA ploidy with survival. The mean age was 45 years, with a mean duration of colitis of 21 years. Five patients (10%) had Dukes' A lesions, 17 (33%) had Dukes' B lesions, 17 (33%) had Dukes' C lesions, and 13 (25%) had distant metastases. Thirty patients (58%) had well- or moderately differentiated tumors, whereas tumors were poorly differentiated in 22 (42%). Twenty-eight patients (54%) had colloid tumors, and, in 14 (27%), signet ring cells were present. Thirty-one patients (60%) had nondiploid tumors. Actuarial analysis revealed that the 5-year survival rate was significantly worse for patients with nondiploid tumors (76% versus 32%). When stratified by stage, only patients with Dukes' C lesions showed a significant difference in survival for diploid versus non-diploid tumors. Multivariate analysis showed that the Dukes' classification was the best prognostic indicator, followed by tumor differentiation and DNA ploidy. Tumor location, colloid content, number of cancers, duration of disease, age, and sex did not correlate with the prognosis.