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中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (03) : 203 -207. doi: 10.3877/cma.j.issn.1674-0785.2020.03.010

所属专题: 文献

医疗援藏·临床研究

西藏地区藏族直肠癌的单中心分析
金璿1, 德庆旺姆2, 拥桑拉姆2, 刘章程2, 赵玉兰2,()   
  1. 1. 100034 北京大学第一医院肿瘤化疗科;850000 拉萨,西藏自治区人民医院肿瘤科
    2. 850000 拉萨,西藏自治区人民医院肿瘤科
  • 收稿日期:2020-02-12 出版日期:2020-03-15
  • 通信作者: 赵玉兰

A single-center analysis of colorectal cancer in Tibet

Xuan Jin1, Wangmu DeQing2, Lamu YongSang2, Zhangcheng Liu2, Yulan Zhao2,()   

  1. 1. Department of Medical Oncology, Peking University First Hospital, Beijing 100034, China; Department of Oncology, Tibet Autonomous Region People’s Hospital, Lhasa 850000, China
    2. Department of Oncology, Tibet Autonomous Region People’s Hospital, Lhasa 850000, China
  • Received:2020-02-12 Published:2020-03-15
  • Corresponding author: Yulan Zhao
  • About author:
    Corresponding author: Zhao Yulan, Email:
引用本文:

金璿, 德庆旺姆, 拥桑拉姆, 刘章程, 赵玉兰. 西藏地区藏族直肠癌的单中心分析[J/OL]. 中华临床医师杂志(电子版), 2020, 14(03): 203-207.

Xuan Jin, Wangmu DeQing, Lamu YongSang, Zhangcheng Liu, Yulan Zhao. A single-center analysis of colorectal cancer in Tibet[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(03): 203-207.

目的

了解世居藏族直肠癌的临床病理特征及诊治现状,为西藏自治区直肠癌的规范化诊疗提供参考。

方法

回顾2016年1月至2019年12月西藏自治区人民医院收治的64例高原世居藏族直肠癌患者的病历资料。

结果

64例患者中男性42例,女性22例,平均年龄(58.3±11.4)岁。最常见临床症状为大便带血。中下段直肠癌占比78.1%(50/64),其中,仅24%(12/50)的患者接受盆腔增强磁共振检查。Ⅰ期2例(3.1%),Ⅱ期13例(20.3%),Ⅲ期21例(32.8%),Ⅳ期28例(43.8%)。13例(20.3%)患者接受错配修复蛋白检测,19例(29.7%)接受人表皮生长因子受体2检测,无患者接受基因检测。全组患者中,33例(51.6%)接受手术,其中23例(69.7%)手术在西藏自治区完成;28例Ⅳ期及3例根治术后复发转移的患者中,19例(61.3%)接受全身化疗。无患者接受术前同步放化疗,亦无患者通过多学科团队制定治疗方案。

结论

高原世居藏族直肠癌发病率在40岁开始快速上升,男性居多。中低位直肠癌患者盆腔增强磁共振检查率低,导致临床分期不准确。西藏地区亟待建立放疗专业,并进一步强化多学科团队理念,使更多藏族患者获益。

Objective

To investigate the clinicopathological characteristics, diagnosis, and treatment of rectal cancer in Tibet, in order to provide reference for the standardized diagnosis and treatment of this malignancy in Tibet Autonomous region.

Methods

The medical records of 64 Tibetan patients with rectal cancer who were hospitalized at Tibet Autonomous Region People’s Hospital from January 2016 to December 2019 were retrospectively analyzed.

Results

A total of 64 patients were included, with an average age of (58.3±11.4) years, including 42 males and 22 females. The most common clinical symptom was bloody stool. The proportion of middle and low rectal cancer was 78.1% (50/64), and among patients with middle and low rectal cancer, only 24% (12/50) underwent pelvic enhanced magnetic resonance imaging (MRI). There were two (3.1%) cases with stage Ⅰ disease, 13 (20.3%) with stage Ⅱ, 21 (32.8%) with stage Ⅲ, and 28 (43.8%) with stage Ⅳ. Thirteen (20.3%) patients received mismatch repair protein test, 19 (29.7%) received human epidermal growth factor receptor-2 test by immunohistochemical method, and no patients received gene test. Thirty-three (51.6%) patients received surgery, of whom 23 (69.7%) were operated in Tibet Autonomous Region. Among 28 patients with stage Ⅳ and three patients with recurrence and/or metastasis after radical operation, 19 (61.3%) received systemic chemotherapy. No patients received preoperative concurrent chemoradiotherapy, and no patients had treatment plans formulated through a multidisciplinary team (MDT).

Conclusion

The incidence of rectal cancer in Tibetan begins to rise rapidly at the age of 40, with the majority being male. The low rate of pelvic enhanced MRI examination in patients with middle and low rectal cancer leads to inaccurate clinical staging. There is an urgent need to establish a radiotherapy specialty in Tibet and further strengthen the concept of MDT, so as to benefit more Tibetan patients.

表1 64例西藏藏族直肠癌患者年龄及性别分布情况
表2 64例西藏藏族直肠癌患者的临床病理特征
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