结肠直肠黏液癌与印戒细胞癌的10年效果评价

作     者：O'Connell J.B. Maggard M.A. C.Y. Ko 成虹 

作者机构：Department of Surgery David Geffen School of Medicine at UCLA 72- 215 CHS 10833 Le Conte Avenue Los Angeles CA 90095 United StatesDr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2005年第1卷第11期

页      面：11-11页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：印戒细胞癌 结肠直肠 效果评价 黏液癌 大肠腺癌 肿瘤分级 肿瘤分期 晚期肿瘤 数据分析 百分比变化 

摘      要：PURPOSE: Most studies examining mucinous or signet-ring cell colorectal cancers are single institution reports. This study used a national cancer registry to analyze the epidemiology and survival outcomes of these two subtypes of colorectal cancer compared with adenocarcinoma tumors. METHODS: All patients diagnosed with mucinous (n = 16,991), signet-ring cell (n = 1,522), or adenocarcinoma (n = 146,115) colorectal cancer in the Surveillance, Epidemiology, and End Results database (1991- 2000) were evaluated. Analyses were performed to obtain age-adjusted incidence rates, stage at presentation, tumor grade, and five-year relative survival for each subtype. RESULTS: Mucinous were slightly morin females (53.4 percent). Incidence rates per 100,000 persons were: mu-cinous, 5.5; signet-ring cell, 0.6; and adenocarcinoma 46.6. The annual percent change during ten years was stable for mucinous, increased for signet-ring cell (4.8 percent; P 0.05), and decreased for adenocarcinoma (- 1.1 percent; P 0.05). Fewer mucinous (18 percent) and signet-ring cell (21 percent) tumors were located in the rectum compared with adenocarcinoma (29 percent). Signet-ring cell presented at later stage (III/IV, 80.9 percent) more often than mucinous (52.8 percent) and adenocarcinoma (49.5 percent), and also had worse tumor grade (high grade: signet-ring cell, 73.5 percent; mucinous, 20.9 percent; adenocarcinoma, 17.5 percent). Rela-tive five-year survival was worse for signet-ring cell than mucinous or adenocarcinoma. CONCLUSIONS: We present a large population-based review of colorectal cancer subtypes by analyzing national data from the past decade. Although the incidence of colorectal adenocarcinoma is decreasing in the United States, mucinous and signet-ring cell subtypes are stable and increasing, respectively. Importantly, it seems that the signet-ring cell subtype has worse outcomes, whereas survival rates for mucinous tumors are similar to adenocarcinomas.