复发转移性结直肠癌的早期诊断及治疗

Early Diagnosis and Treatment of Recurrent and Metastatic Colorectal Cancer

摘要: 随着生活方式和饮食结构的改变，结直肠癌的发病率和死亡率呈现逐年升高的趋势，已成为在世界上威胁人类健康的最常见的恶性肿瘤之一。随着人们健康意识的提高，结直肠癌及早被发现。其治疗的方式主要为手术切除治疗，但是5年生存率仍较低，一般结直肠癌根治术后复发率达1/3左右，占治疗失败病人的80%以上。其死亡的主要原因是远处转移和复发。包括肿瘤切除区域局部复发、临近脏器、引流区域淋巴结、腹壁切口、肝脏、骨骼、肺等的转移癌。上述复发类型可并存，形成腹腔内广泛区域性复发。结直肠癌复发转移后若不治疗的5年生存率不足5%；而再次手术根治后5年生存率可达30%~50%，可以和首次手术的效果相媲美。所以早期诊断和及时治疗复发转移性结直肠癌仍是医学上值得探讨的话题。

Abstract: With the changes in lifestyle and diet, the incidence and mortality of colorectal cancer are increasing year by year, and it has become one of the most common malignant tumors that threaten human health in the world. With the improvement of people’s health awareness, colorectal cancer is found early. The main method of treatment is surgical resection, but the 5-year survival rate is still low. Generally, the recurrence rate after radical resection of colorectal cancer is about 1/3, accounting for more than 80% of patients with treatment failure. The main cause of his death was distant metastasis and recurrence, including local recurrence in the area where the tumor was removed, metastatic cancers in adjacent organs, drainage area lymph nodes, abdominal wall incisions, liver, bones, lungs, etc. The above recurrence types can coexist, forming extensive regional recurrence in the abdominal cavity. After colorectal cancer recurrence and metastasis, the 5-year survival rate without treatment is less than 5%; and the 5-year survival rate after reoperation can reach 30%~50%, which can be comparable to the effect of the first operation. Therefore, early diagnosis and timely treatment of recurrent and metastatic colorectal cancer are still topics worth discussing in medicine.