摘要
目的探讨中原地区遗传性非息肉病性大肠癌(HNPCC)的表型特征,为制订适合我国国情的HNPCC遴选标准提供依据。方法对符合Am sterdam标准的8个家系37例患者的临床资料(A组),与随机抽调我院40例确切无家族史的大肠癌患者的临床资料(B组)进行对比分析。结果①发病年龄:A组平均46岁,B组62.6岁,平均提前16.6年;<50岁者:A组73%(27/37),B组30%(12/40),两组比较P<0.01;第1、2、3代平均发病年龄分别为69.2、46.9、34.6岁,逐代比较差异有统计学意义(P<0.05或P<0.01)。②发病部位:右半结肠A组73.2%(30/41),B组39.0%(16/41),两组比较P<0.05。③同时、异时多发大肠癌:A组8.1%(3/37),B组2.5%(1/40)。④大肠外癌:A组17.1%(7/41),B组0,两组比较P<0.05。⑤合并腺瘤:A组0,B组22.5%(9/40),两组比较P<0.05。⑥组织学类型:低分化腺癌A组69.7%(23/33),B组40%(16/40),两组比较P<0.05。结论中原地区HNPCC有其独特的临床特征,国际遴选标准不能完全适用于中国人,制定适合我国国情的HNPCC遴选标准确有必要。
Objective To investigate the phenotype feature of hereditary nonpolyposis colorectal cancer （HNPCC） in the population of middle area in China and to provide scientific basis for formulating the diagnosis criteria of HNPCC suitable for Chinese . Methods Data of 37 patients from 8 HNPCC families diagnosed according to Amsterdam criteria （group A） and of 40 patients random selected from our hospital with colorectal cancer and without family history were collected and comparatively analyzed. Results ①The cancer occurred earlier by 16.6 years in average in guoup A（average ,46 years ） than in group B（average , 62.6 years）. 73% of them in group A（27/37） and 30% of them in group B （12/40） developed the cancer before 50 years （ P 〈 0.01 ）. The average age of confirmed diagnosis of HNPCC in the first , the second , and the third generation of the family people was respectively 69.2 , 46.9, and 34.6 years . There was a significant difference between the two generations in sequence （ P 〈 0.05 or P 〈 0.01 ）. ②The cancer foci occurred in right half of colon in 30 cases in group A （73.1% , 30/41 ） and in 16 cases in group B （39.0% ,16/41 ） （P 〈 0.05） . ③There were 3 cases of synchronous and/or metachronous primary colorectal cancer in group A （8.1% ,3/37 ） and one case in group B （2.5 %, 1/40）. ④Seven patients suffered from cancer in other organs in group A（17.1% ,7/41） and no one in group B （ P 〈0.05）. ⑤There was no patient complicated by adenoma in group A and 9 patients in group B （22.5%, 9/40） （ P 〈 0.05）. ⑥There were 23 cases of glandular cancer in low degree of pathological differentiation in group A （69.7% ,23/33） and 16 cases in group B （40% , 16/40）（ P 〈 0.05） . Conclusion HNPCC has typical clinical features in the population of middle area in China . International diagnosis criteria is not completely suitable for Chinese and it is necessary to formulate the diagnosis criteria of HNPCC suitable for Chinese.
出处
《中原医刊》
2006年第14期14-18,共5页
Central Plains Medical Journal
基金
国家科技攻关计划项目课题(2002BA711A07)
