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題名 | Primary Diffusely Infiltrative Adenocarcinoma of the Colon and Rectum=原發散布瀰漫性大腸直腸癌 |
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作者姓名(中文) | 唐瑞平; 王正儀; 陳進勛; 張簡俊榮; 許寬成; 林尚潁; 何逸僊; 范宏二; | 書刊名 | 長庚醫學 |
卷期 | 20:4 1997.12[民86.12] |
頁次 | 頁264-271 |
分類號 | 416.245 |
關鍵詞 | 大腸直腸癌; 原發散布瀰漫性腺癌; Colorectal cancer; Diffusely infiltrative adenocarcinoma; |
語文 | 英文(English) |
中文摘要 | 背景:希望更清楚地描述原發散布瀰漫性大腸直腸癌的黏膜變異和分析他們臨床 病理特性和存活率的相關性。 方法:我們回顧分析30例在同一醫院手術此類型腫瘤的病人。 結果:平均被診斷時年齡是47.4歲(標準差19.3),18個腫瘤位於直腸。這些腫瘤可分成2 種主要類型。型式1沒有顯著中央潰爛。型式2腫瘤有著一個(從1 cm至4cm不等大小)中 央潰爛,這些潰爛(不管大或小)的邊緣都不會凸起。型1的腫瘤經常伴隨細胞內或細胞外 黏液生成和第IV期的疾病,血源性散布(包含腹膜性癌增生)較常見在型1腫瘤中(68% vs 18% p=0.013),總觀的平均存活率是15個月(標準誤差3;95%信賴誤差區間10-21),TNM 分期在預期結果(P=0.016)中是唯一明顯的因素,當和II及III期比較起來,第IV期死 亡勝算比是2.9(95%信賴區間:1.1-7.4)。 結論:這種散發式瀰漫性大腸直腸癌是一種罕見型態的大腸直腸癌,根據黏膜潰爛的出現、 他們可被分類成2種亞型,第1型(沒有顯著潰爛)常伴隨著較高血源性傳播力,而在決定 結果時,腫瘤的分期則是唯一的臨床病理因子。 |
英文摘要 | Background: Primary diffusely infiltrative colorectal adenocardnoma is rare. About 100 cases have been reported in the literature. The mucosal alterations in this type of tumor and their clinicopathological characteristics in relation to survival are not clear. Methods: We retrospectively reviewed 30 cases of primary diffusely infiltrative colorectal adenocarcinoma operated upon in a single institution. Results: Eighteen (60%) of these 30 patients were women. The average age at diagnosis was 47.4 (SD, 19.3) years. Eighteen tumors (60%) were located in the rectum. The tumors could be classified into two major types. A type 1 tumor had minimal mucosal alteration and no discrete ulcer. A type 2 tumor was associated with a discrete ulcer. The type 1 tumor was more frequently associated with intracellular or extracellular mucin production and stage IV disease. Hematogenous spread (including peritoneal carcinomatosis) was more frequently seen in type I than in the type 2 tumors (61% vs. 18%, p = 0.013). The overall median cancer-specific survival time was 15 (SE, 3; 95% confidence interval, 10-21) months. TNM stage is the only significant factor in predicting outcome (p = 0.016). When compared with stages II and III, the odds of death for stage IV was 2.9 (95% confidence interval: 1.1-7.4). Conclusion: Diffusely infiltrative colorectal cancer can he separated into two subtypes according to the presence of a discrete ulcer. The type I tumor (without a discrete ulcer) was associated with a higher frequency of hematogenous spread. TNM Stage was the onlv important clinicopathological factor in determining outcome. |
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